81206

Translocation analysis (bcr/abl1) major breakpoint

Medicare pricing data for 198 providers across 33 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

Translocation analysis (bcr/abl1) major breakpoint (HCPCS code 81206) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $160.14, but hospitals typically charge $439.72 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$32.03

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $160.14, your out-of-pocket cost would be approximately $32.03. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$160.14
Average Hospital Charge
$439.72
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$439.72
Medicare Allowed$160.14
Medicare Payment$160.14

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $160.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$161$3004489+0.5%
Georgia$161$4101119+0.3%
Hawaii$161$456264+0.3%
Iowa$161$711233+0.3%
Kentucky$161$8201189+0.3%
Maine$161$268269+0.3%
Massachusetts$161$6002232+0.3%
Michigan$161$2941276+0.3%
North Carolina$161$643214+0.3%
Oklahoma$161$4304227+0.3%
Oregon$161$279319+0.3%
South Dakota$161$568242+0.3%
Tennessee$161$3495732+0.3%
Utah$161$3282690+0.3%
Puerto Rico$161$164120+0.3%
Colorado$161$6083187+0.3%
Connecticut$161$6144698+0.3%
Texas$161$479172,901+0.3%
Florida$160$352176,571+0.2%
New York$160$50211434+0.1%
New Mexico$160$7551127+0.1%
New Jersey$160$40194,576+0.1%
Ohio$160$496579+0.0%
Maryland$160$5926413-0.1%
Minnesota$160$810171,869-0.1%
Illinois$160$4246466-0.3%
Pennsylvania$160$6226422-0.3%
Washington$160$3836345-0.4%
California$160$26762,336-0.4%
Virginia$159$3212154-0.8%
Alabama$159$60023371-1.0%
Wisconsin$158$7285331-1.4%
Indiana$120$287255-25.0%

⚠️ 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