Urine pregnancy test
Medicare pricing data for 22,125 providers across 51 states
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
Urine pregnancy test (HCPCS code 81025) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.26, but hospitals typically charge $28.02 — a 3.4x 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 $8.26, your out-of-pocket cost would be approximately $1.65. 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 3.4x more than what Medicare allows for this procedure. Medicare actually pays $8.26 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| North Dakota | $8 | $33 | 28 | 66 | +2.2% |
| Utah | $8 | $17 | 70 | 87 | +2.2% |
| Alaska | $8 | $37 | 54 | 99 | +1.8% |
| Nevada | $8 | $33 | 139 | 221 | +1.7% |
| Rhode Island | $8 | $25 | 81 | 450 | +1.7% |
| District of Columbia | $8 | $35 | 141 | 281 | +1.5% |
| Mississippi | $8 | $26 | 330 | 771 | +1.5% |
| Pennsylvania | $8 | $33 | 906 | 1,907 | +1.5% |
| California | $8 | $32 | 1,325 | 2,810 | +1.5% |
| West Virginia | $8 | $22 | 164 | 749 | +1.3% |
| Delaware | $8 | $23 | 80 | 125 | +1.2% |
| Massachusetts | $8 | $23 | 988 | 3,069 | +1.2% |
| Kentucky | $8 | $18 | 331 | 880 | +1.1% |
| Maine | $8 | $30 | 96 | 130 | +1.1% |
| Montana | $8 | $26 | 58 | 68 | +1.1% |
| New Hampshire | $8 | $35 | 189 | 292 | +1.1% |
| Louisiana | $8 | $26 | 332 | 647 | +1.0% |
| Vermont | $8 | $19 | 70 | 159 | +1.0% |
| Virginia | $8 | $25 | 618 | 1,030 | +1.0% |
| Wisconsin | $8 | $40 | 368 | 1,003 | +1.0% |
| Maryland | $8 | $29 | 706 | 1,888 | +0.8% |
| Connecticut | $8 | $30 | 350 | 579 | +0.8% |
| Idaho | $8 | $21 | 85 | 131 | +0.7% |
| Arkansas | $8 | $21 | 366 | 789 | +0.7% |
| Colorado | $8 | $24 | 321 | 569 | +0.7% |
| Minnesota | $8 | $30 | 622 | 967 | +0.6% |
| Iowa | $8 | $28 | 274 | 397 | +0.5% |
| Oklahoma | $8 | $30 | 322 | 538 | +0.5% |
| Illinois | $8 | $37 | 852 | 1,377 | +0.2% |
| Nebraska | $8 | $25 | 153 | 229 | +0.2% |
| North Carolina | $8 | $30 | 1,160 | 2,254 | +0.1% |
| Indiana | $8 | $24 | 700 | 1,587 | 0.0% |
| Missouri | $8 | $30 | 497 | 871 | 0.0% |
| Ohio | $8 | $21 | 514 | 1,066 | 0.0% |
| South Carolina | $8 | $30 | 469 | 871 | 0.0% |
| New Jersey | $8 | $35 | 565 | 1,253 | -0.1% |
| New York | $8 | $30 | 1,817 | 3,667 | -0.2% |
| Oregon | $8 | $26 | 188 | 266 | -0.4% |
| South Dakota | $8 | $29 | 39 | 70 | -0.4% |
| Wyoming | $8 | $36 | 31 | 40 | -0.4% |
| Kansas | $8 | $30 | 221 | 356 | -0.6% |
| Michigan | $8 | $24 | 1,026 | 2,599 | -0.6% |
| Texas | $8 | $30 | 1,033 | 1,892 | -0.6% |
| Georgia | $8 | $28 | 855 | 1,611 | -0.8% |
| Arizona | $8 | $27 | 248 | 479 | -1.7% |
| New Mexico | $8 | $30 | 136 | 193 | -1.8% |
| Tennessee | $8 | $28 | 633 | 1,893 | -2.4% |
| Florida | $8 | $29 | 723 | 1,429 | -2.9% |
| Washington | $8 | $25 | 385 | 637 | -3.6% |
| Hawaii | $8 | $29 | 28 | 51 | -4.4% |
| Alabama | $8 | $20 | 414 | 1,034 | -6.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber