80184

Phenobarbital level

Medicare pricing data for 433 providers across 44 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $80.60 but Medicare allows only $14.96. Uninsured patients may face bills 5.4 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

Phenobarbital level (HCPCS code 80184) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.96, but hospitals typically charge $80.60 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.96, your out-of-pocket cost would be approximately $2.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.96
Average Hospital Charge
$80.60
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$80.60
Medicare Allowed$14.96
Medicare Payment$14.96

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $14.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$15$26222+0.2%
Georgia$15$9171,012+0.2%
Illinois$15$7037917+0.2%
Indiana$15$88437+0.2%
Iowa$15$49661+0.2%
Kansas$15$1016476+0.2%
Kentucky$15$28563+0.2%
Louisiana$15$547376+0.2%
Maine$15$41239+0.2%
Maryland$15$9710268+0.2%
Michigan$15$379223+0.2%
Mississippi$15$614102+0.2%
Missouri$15$37539+0.2%
Nebraska$15$41214+0.2%
New Hampshire$15$72521+0.2%
New Jersey$15$107122,275+0.2%
New Mexico$15$222239+0.2%
New York$15$9112354+0.2%
North Dakota$15$56731+0.2%
Oklahoma$15$637277+0.2%
Oregon$15$63561+0.2%
Pennsylvania$15$7812432+0.2%
Rhode Island$15$33128+0.2%
South Carolina$15$36582+0.2%
Tennessee$15$757302+0.2%
Utah$15$30533+0.2%
Wisconsin$15$977184+0.2%
Puerto Rico$15$191222+0.2%
Alabama$15$958564+0.2%
Arizona$15$1005233+0.2%
Arkansas$15$30385+0.2%
Colorado$15$885125+0.2%
Florida$15$62231,807+0.1%
Nevada$15$464399+0.1%
Ohio$15$81201,364+0.1%
California$15$77331,786+0.1%
North Carolina$15$89122,2600.0%
South Dakota$15$48463-0.1%
Texas$15$86331,617-0.5%
Minnesota$15$8731138-0.5%
Washington$15$828130-0.6%
Massachusetts$15$707746-1.1%
Virginia$15$5017387-1.1%
Hawaii$14$61239-4.3%

⚠️ 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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