Clozapine level
Medicare pricing data for 207 providers across 34 states
This procedure has a 6.2x markup — hospitals charge $122.46 but Medicare allows only $19.72. Uninsured patients may face bills 6.2 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
Clozapine level (HCPCS code 80159) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.72, but hospitals typically charge $122.46 — a 6.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.72, your out-of-pocket cost would be approximately $3.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $19.72 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $20 | $123 | 11 | 718 | +0.2% |
| Georgia | $20 | $126 | 4 | 569 | +0.2% |
| Hawaii | $20 | $88 | 1 | 89 | +0.2% |
| Idaho | $20 | $49 | 1 | 130 | +0.2% |
| Illinois | $20 | $139 | 13 | 541 | +0.2% |
| Iowa | $20 | $60 | 5 | 47 | +0.2% |
| Kansas | $20 | $116 | 5 | 580 | +0.2% |
| Maine | $20 | $42 | 2 | 232 | +0.2% |
| Maryland | $20 | $133 | 5 | 552 | +0.2% |
| Minnesota | $20 | $212 | 7 | 376 | +0.2% |
| Missouri | $20 | $58 | 5 | 81 | +0.2% |
| Nevada | $20 | $61 | 2 | 544 | +0.2% |
| New Mexico | $20 | $100 | 1 | 34 | +0.2% |
| New York | $20 | $118 | 8 | 1,615 | +0.2% |
| Ohio | $20 | $134 | 8 | 608 | +0.2% |
| Oklahoma | $20 | $87 | 5 | 203 | +0.2% |
| Pennsylvania | $20 | $106 | 7 | 571 | +0.2% |
| Rhode Island | $20 | $35 | 2 | 86 | +0.2% |
| Tennessee | $20 | $133 | 2 | 122 | +0.2% |
| Texas | $20 | $137 | 13 | 676 | +0.2% |
| Utah | $20 | $62 | 6 | 296 | +0.2% |
| Virginia | $20 | $123 | 5 | 340 | +0.2% |
| Washington | $20 | $145 | 2 | 280 | +0.2% |
| Wisconsin | $20 | $50 | 4 | 214 | +0.2% |
| Alabama | $20 | $148 | 2 | 232 | +0.2% |
| Arizona | $20 | $125 | 3 | 635 | +0.2% |
| California | $20 | $108 | 25 | 6,121 | +0.2% |
| Colorado | $20 | $133 | 7 | 748 | +0.2% |
| Oregon | $20 | $83 | 5 | 184 | +0.1% |
| North Carolina | $20 | $138 | 5 | 4,025 | +0.1% |
| New Jersey | $20 | $156 | 5 | 2,929 | 0.0% |
| Massachusetts | $20 | $122 | 5 | 2,505 | -0.4% |
| South Dakota | $19 | $87 | 4 | 77 | -1.8% |
| Michigan | $17 | $61 | 9 | 157 | -12.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber