81219

Gene analysis (calreticulin), common variants

Medicare pricing data for 241 providers across 25 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 (calreticulin), common variants (HCPCS code 81219) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $118.99, but hospitals typically charge $415.81 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$23.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $118.99, your out-of-pocket cost would be approximately $23.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$118.99
Average Hospital Charge
$415.81
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$415.81
Medicare Allowed$118.99
Medicare Payment$118.99

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $118.99 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$119$304185+0.2%
Illinois$119$32818205+0.2%
Iowa$119$506113+0.2%
Maryland$119$380475+0.2%
Massachusetts$119$3674124+0.2%
Missouri$119$490124+0.2%
New Jersey$119$4265704+0.2%
New Mexico$119$409134+0.2%
North Carolina$119$6123126+0.2%
Oklahoma$119$284317+0.2%
Pennsylvania$119$3664104+0.2%
Tennessee$119$3323449+0.2%
Utah$119$2452192+0.2%
Virginia$119$368240+0.2%
Wisconsin$119$559342+0.2%
Colorado$119$395328+0.2%
Arizona$119$6233970+0.1%
Connecticut$119$4933450+0.0%
Texas$119$33310815+0.0%
California$119$339101,0270.0%
Minnesota$119$74421443-0.0%
New York$119$528811,105-0.1%
Washington$119$450988-0.1%
Florida$119$321152,935-0.1%
Michigan$116$3141633-2.2%

⚠️ 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