Gene analysis (adenomatous polyposis coli), full gene sequence
Medicare pricing data for 54 providers across 6 states
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
Gene analysis (adenomatous polyposis coli), full gene sequence (HCPCS code 81201) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $764.07, but hospitals typically charge $898.56 — a 1.2x 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 $764.07, your out-of-pocket cost would be approximately $152.81. 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 1.2x more than what Medicare allows for this procedure. Medicare actually pays $764.07 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $764 | $780 | 2 | 36 | +0.0% |
| Maryland | $764 | $900 | 1 | 13 | +0.0% |
| Pennsylvania | $764 | $781 | 2 | 1,021 | +0.0% |
| New Jersey | $764 | $935 | 11 | 1,782 | +0.0% |
| Florida | $764 | $915 | 20 | 4,042 | +0.0% |
| Texas | $759 | $855 | 11 | 246 | -0.7% |
⚠️ 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