80175

Lamotrigine level

Medicare pricing data for 397 providers across 42 states

🤖AI Overview

This procedure has a 8.6x markup — hospitals charge $111.29 but Medicare allows only $12.95. Uninsured patients may face bills 8.6 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

Lamotrigine level (HCPCS code 80175) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.95, but hospitals typically charge $111.29 — a 8.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.95, your out-of-pocket cost would be approximately $2.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.95
Average Hospital Charge
$111.29
Markup Ratio
8.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$111.29
Medicare Allowed$12.95
Medicare Payment$12.95

Hospitals charge 8.6x more than what Medicare allows for this procedure. Medicare actually pays $12.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$13$16230+0.2%
Georgia$13$1155990+0.2%
Hawaii$13$60242+0.2%
Idaho$13$32218+0.2%
Kentucky$13$194126+0.2%
Maine$13$742182+0.2%
Maryland$13$965318+0.2%
Mississippi$13$91657+0.2%
Missouri$13$23467+0.2%
Nevada$13$1191145+0.2%
New Hampshire$13$77434+0.2%
New Jersey$13$132103,428+0.2%
New Mexico$13$109141+0.2%
New York$13$409804+0.2%
North Dakota$13$46842+0.2%
Pennsylvania$13$1128681+0.2%
Rhode Island$13$52116+0.2%
South Dakota$13$714152+0.2%
Virginia$13$598361+0.2%
California$13$107272,470+0.2%
Colorado$13$1298310+0.2%
Florida$13$101132,002+0.2%
North Carolina$13$154125,333+0.2%
Ohio$13$63151,446+0.2%
Texas$13$128292,052+0.2%
Oklahoma$13$558550+0.1%
Tennessee$13$888291+0.1%
Washington$13$1137340+0.1%
Alabama$13$1546373+0.1%
Illinois$13$89167210.0%
Massachusetts$13$9481,2950.0%
Oregon$13$8662700.0%
Utah$13$316290-0.1%
Kansas$13$12010650-0.4%
Arizona$13$1284395-0.5%
Minnesota$13$13275670-0.8%
Wisconsin$13$5411527-0.8%
Indiana$13$166270-1.0%
Michigan$13$4012210-1.3%
South Carolina$12$48851-4.2%
Iowa$12$44663-5.2%
Arkansas$10$10173-22.4%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber