80202

Vancomycin (antibiotic) level

Medicare pricing data for 405 providers across 39 states

🤖AI Overview

This procedure has a 7.6x markup — hospitals charge $101.31 but Medicare allows only $13.25. Uninsured patients may face bills 7.6 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

Vancomycin (antibiotic) level (HCPCS code 80202) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.25, but hospitals typically charge $101.31 — a 7.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.65

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.25, your out-of-pocket cost would be approximately $2.65. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$13.25
Average Hospital Charge
$101.31
Markup Ratio
7.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$101.31
Medicare Allowed$13.25
Medicare Payment$13.25

Hospitals charge 7.6x more than what Medicare allows for this procedure. Medicare actually pays $13.25 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$13$887406+0.2%
Illinois$13$69212,242+0.2%
Indiana$13$48449+0.2%
Kansas$13$1388803+0.2%
Kentucky$13$275128+0.2%
Louisiana$13$757296+0.2%
Maine$13$74267+0.2%
Maryland$13$3911722+0.2%
Massachusetts$13$10391,169+0.2%
Michigan$13$4711208+0.2%
Minnesota$13$691876+0.2%
Missouri$13$1198405+0.2%
New Mexico$13$83145+0.2%
New York$13$130102,264+0.2%
Ohio$13$66152,064+0.2%
Oklahoma$13$1016595+0.2%
Oregon$13$75577+0.2%
Pennsylvania$13$1339451+0.2%
Rhode Island$13$691140+0.2%
South Carolina$13$64333+0.2%
Utah$13$545279+0.2%
Washington$13$9210390+0.2%
Arkansas$13$202135+0.2%
California$13$120476,894+0.2%
Colorado$13$767490+0.2%
Mississippi$13$9987,126+0.1%
New Jersey$13$131119,653+0.1%
North Carolina$13$9392,630+0.1%
Texas$13$109363,874+0.1%
Florida$13$82347,2680.0%
Virginia$13$5881,3560.0%
Alabama$13$94127140.0%
Tennessee$13$769969-0.1%
Arizona$13$12331,723-0.2%
Connecticut$13$1593198-0.7%
Nevada$13$5161,051-0.8%
Iowa$13$62658-1.1%
Hawaii$13$662149-1.6%
Wisconsin$12$9610422-6.0%

⚠️ 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