Sirolimus level
Medicare pricing data for 202 providers across 28 states
This procedure has a 13.1x markup — hospitals charge $175.61 but Medicare allows only $13.42. Uninsured patients may face bills 13.1 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
Sirolimus level (HCPCS code 80195) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.42, but hospitals typically charge $175.61 — a 13.1x 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 $13.42, your out-of-pocket cost would be approximately $2.68. 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 13.1x more than what Medicare allows for this procedure. Medicare actually pays $13.42 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $13 | $189 | 2 | 304 | +0.3% |
| Illinois | $13 | $191 | 2 | 598 | +0.3% |
| Iowa | $13 | $127 | 3 | 72 | +0.3% |
| Maryland | $13 | $125 | 6 | 713 | +0.3% |
| Massachusetts | $13 | $199 | 6 | 683 | +0.3% |
| Nevada | $13 | $196 | 2 | 171 | +0.3% |
| New Jersey | $13 | $191 | 7 | 2,372 | +0.3% |
| Pennsylvania | $13 | $178 | 4 | 488 | +0.3% |
| South Dakota | $13 | $122 | 2 | 53 | +0.3% |
| Tennessee | $13 | $117 | 3 | 123 | +0.3% |
| Texas | $13 | $166 | 18 | 2,423 | +0.3% |
| Virginia | $13 | $53 | 5 | 244 | +0.3% |
| Alabama | $13 | $193 | 1 | 253 | +0.3% |
| Colorado | $13 | $183 | 6 | 151 | +0.3% |
| California | $13 | $160 | 26 | 3,027 | +0.2% |
| Florida | $13 | $212 | 7 | 2,208 | +0.1% |
| Kansas | $13 | $162 | 5 | 591 | +0.1% |
| Minnesota | $13 | $252 | 18 | 825 | +0.1% |
| New York | $13 | $143 | 6 | 354 | +0.1% |
| Arizona | $13 | $160 | 5 | 1,669 | +0.1% |
| Ohio | $13 | $157 | 10 | 443 | -0.1% |
| Oregon | $13 | $107 | 5 | 152 | -0.1% |
| North Carolina | $13 | $190 | 6 | 2,064 | -0.3% |
| New Mexico | $13 | $163 | 3 | 135 | -0.4% |
| Washington | $13 | $150 | 5 | 421 | -0.4% |
| Oklahoma | $13 | $182 | 4 | 757 | -1.0% |
| Hawaii | $13 | $160 | 2 | 106 | -3.3% |
| Wisconsin | $13 | $114 | 5 | 277 | -4.9% |
⚠️ 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