Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence
Medicare pricing data for 33 providers across 9 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 (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence (HCPCS code 81218) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $237.06, but hospitals typically charge $256.26 — a 1.1x 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 $237.06, your out-of-pocket cost would be approximately $47.41. 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 1.1x more than what Medicare allows for this procedure. Medicare actually pays $237.06 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $237 | $245 | 12 | 6,588 | 0.0% |
| Georgia | $237 | $605 | 1 | 29 | 0.0% |
| Maryland | $237 | $335 | 1 | 27 | 0.0% |
| New Jersey | $237 | $574 | 1 | 34 | 0.0% |
| Pennsylvania | $237 | $242 | 2 | 14 | 0.0% |
| Utah | $237 | $484 | 1 | 13 | 0.0% |
| Washington | $237 | $600 | 2 | 17 | 0.0% |
| California | $237 | $564 | 2 | 60 | 0.0% |
| Connecticut | $237 | $826 | 2 | 35 | 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.
💊 Need post-procedure medications? Check costs on OpenPrescriber