81191

Gene analysis (neurotrophic receptor tyrosine kinase 1) translocation analysis

Medicare pricing data for 34 providers across 8 states

🤖AI Overview

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

Gene analysis (neurotrophic receptor tyrosine kinase 1) translocation analysis (HCPCS code 81191) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $203.14, but hospitals typically charge $224.69 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$40.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $203.14, your out-of-pocket cost would be approximately $40.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$203.14
Average Hospital Charge
$224.69
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$224.69
Medicare Allowed$203.14
Medicare Payment$203.14

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $203.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$203$210118+0.0%
New Jersey$203$25233,038+0.0%
Oklahoma$203$2603245+0.0%
Pennsylvania$203$20711,106+0.0%
Texas$203$212126,257+0.0%
Arizona$203$250160+0.0%
Colorado$203$911114+0.0%
Florida$203$223112,234-0.0%

⚠️ 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