81207

Translocation analysis (bcr/abl1) minor breakpoint

Medicare pricing data for 147 providers across 21 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) minor breakpoint (HCPCS code 81207) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $141.61, but hospitals typically charge $311.63 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $141.61, your out-of-pocket cost would be approximately $28.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$141.61
Average Hospital Charge
$311.63
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$311.63
Medicare Allowed$141.61
Medicare Payment$141.61

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $141.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$142$2406224+0.6%
Hawaii$142$410120+0.2%
Illinois$142$2082213+0.2%
Massachusetts$142$2102104+0.2%
New Mexico$142$411141+0.2%
New York$142$4796188+0.2%
Oklahoma$142$279158+0.2%
Texas$142$30315781+0.2%
Utah$142$290191+0.2%
Wisconsin$142$389531+0.2%
Arizona$142$2603155+0.2%
Colorado$142$252372+0.2%
Connecticut$142$5543671+0.2%
Minnesota$142$4219429+0.2%
Florida$142$285162,950+0.1%
New Jersey$142$26493,908+0.0%
Maryland$141$3385225-0.1%
Washington$141$2655165-0.5%
Alabama$140$54023367-1.2%
Virginia$139$315230-1.9%
Pennsylvania$138$2795106-2.6%

⚠️ 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