Measurement of lacosamide
Medicare pricing data for 187 providers across 32 states
This procedure has a 7.0x markup — hospitals charge $184.64 but Medicare allows only $26.54. Uninsured patients may face bills 7.0 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Measurement of lacosamide (HCPCS code 80235) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $26.54, but hospitals typically charge $184.64 — a 7.0x 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 $26.54, your out-of-pocket cost would be approximately $5.31. 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 7.0x more than what Medicare allows for this procedure. Medicare actually pays $26.54 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $27 | $193 | 3 | 351 | +0.1% |
| Hawaii | $27 | $136 | 2 | 15 | +0.1% |
| Illinois | $27 | $169 | 6 | 148 | +0.1% |
| Iowa | $27 | $114 | 2 | 12 | +0.1% |
| Kentucky | $27 | $68 | 5 | 26 | +0.1% |
| Louisiana | $27 | $236 | 1 | 14 | +0.1% |
| Maryland | $27 | $173 | 3 | 59 | +0.1% |
| Michigan | $27 | $84 | 6 | 48 | +0.1% |
| Mississippi | $27 | $51 | 4 | 37 | +0.1% |
| Nevada | $27 | $124 | 2 | 67 | +0.1% |
| New Jersey | $27 | $198 | 6 | 878 | +0.1% |
| New York | $27 | $210 | 6 | 443 | +0.1% |
| Ohio | $27 | $129 | 10 | 359 | +0.1% |
| Oregon | $27 | $139 | 4 | 45 | +0.1% |
| Pennsylvania | $27 | $213 | 6 | 193 | +0.1% |
| South Dakota | $27 | $148 | 4 | 52 | +0.1% |
| Tennessee | $27 | $138 | 3 | 79 | +0.1% |
| Texas | $27 | $172 | 19 | 853 | +0.1% |
| Utah | $27 | $102 | 4 | 107 | +0.1% |
| Virginia | $27 | $124 | 8 | 232 | +0.1% |
| Washington | $27 | $233 | 3 | 51 | +0.1% |
| Wisconsin | $27 | $187 | 6 | 158 | +0.1% |
| Alabama | $27 | $217 | 3 | 64 | +0.1% |
| Arizona | $27 | $192 | 4 | 75 | +0.1% |
| California | $27 | $143 | 13 | 620 | +0.1% |
| Colorado | $27 | $160 | 4 | 144 | +0.1% |
| Florida | $27 | $190 | 8 | 636 | 0.0% |
| North Carolina | $27 | $233 | 4 | 1,929 | -0.0% |
| Oklahoma | $26 | $106 | 7 | 218 | -0.3% |
| Kansas | $26 | $200 | 4 | 157 | -0.4% |
| Minnesota | $26 | $178 | 6 | 286 | -0.8% |
| Massachusetts | $26 | $189 | 4 | 214 | -1.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber