80156

Carbamazepine level, total

Medicare pricing data for 751 providers across 45 states

🤖AI Overview

This procedure has a 6.4x markup — hospitals charge $91.56 but Medicare allows only $14.26. Uninsured patients may face bills 6.4 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Carbamazepine level, total (HCPCS code 80156) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.26, but hospitals typically charge $91.56 — a 6.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.26, your out-of-pocket cost would be approximately $2.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.26
Average Hospital Charge
$91.56
Markup Ratio
6.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.56
Medicare Allowed$14.26
Medicare Payment$14.26

Hospitals charge 6.4x more than what Medicare allows for this procedure. Medicare actually pays $14.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$14$23251+0.1%
Florida$14$80262,747+0.1%
Georgia$14$97121,118+0.1%
Hawaii$14$59274+0.1%
Idaho$14$68423+0.1%
Indiana$14$63276+0.1%
Iowa$14$6410107+0.1%
Kentucky$14$3117207+0.1%
Louisiana$14$5021697+0.1%
Maine$14$51361+0.1%
Minnesota$14$87116324+0.1%
Missouri$14$3810131+0.1%
New Hampshire$14$76524+0.1%
New Mexico$14$772117+0.1%
North Dakota$14$81795+0.1%
Oklahoma$14$648575+0.1%
Oregon$14$605191+0.1%
Rhode Island$14$41271+0.1%
South Dakota$14$878172+0.1%
Utah$14$30591+0.1%
Virginia$14$5521549+0.1%
Puerto Rico$14$191321+0.1%
Arkansas$14$2611194+0.1%
Kansas$14$117111,214+0.1%
Massachusetts$14$96451,571+0.1%
New Jersey$14$101184,202+0.1%
New York$14$10014898+0.1%
Alabama$14$11313917+0.1%
Nevada$14$6244850.0%
North Carolina$14$113173,2610.0%
Ohio$14$88192,4500.0%
Texas$14$99513,2550.0%
Pennsylvania$14$10114830-0.1%
Washington$14$9919588-0.1%
Wisconsin$14$10719471-0.1%
California$14$94373,090-0.1%
Colorado$14$968447-0.1%
Illinois$14$84511,830-0.1%
Arizona$14$9115595-0.1%
South Carolina$14$4915161-0.3%
Maryland$14$1018403-0.4%
Michigan$14$3818503-0.4%
Tennessee$14$10112411-0.4%
Mississippi$14$688146-1.0%
Connecticut$14$863165-1.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

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