81226

Gene analysis (cytochrome p450, family 2, subfamily d, polypeptide 6) common variants

Medicare pricing data for 121 providers across 22 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 (cytochrome p450, family 2, subfamily d, polypeptide 6) common variants (HCPCS code 81226) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $440.26, but hospitals typically charge $852.92 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$88.05

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $440.26, your out-of-pocket cost would be approximately $88.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$440.26
Average Hospital Charge
$852.92
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$852.92
Medicare Allowed$440.26
Medicare Payment$440.26

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $440.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kentucky$442$734324+0.4%
Louisiana$442$501341+0.4%
Michigan$442$676190+0.4%
Missouri$442$800115+0.4%
Nevada$442$451173+0.4%
New York$442$902199+0.4%
Oklahoma$442$891240+0.4%
South Carolina$442$9023332+0.4%
Tennessee$442$1,500113+0.4%
Arizona$442$7193397+0.4%
Arkansas$442$902130+0.4%
California$442$928260+0.4%
Colorado$442$1,590252+0.4%
Connecticut$442$1,337143+0.4%
New Jersey$442$519132,134+0.3%
Florida$442$531214,194+0.3%
Mississippi$441$6642124+0.2%
Pennsylvania$441$54851,070+0.1%
Ohio$441$1,29745,874+0.1%
Texas$435$805461,940-1.2%
Virginia$427$5642214-3.1%
Indiana$423$474154-3.9%

⚠️ 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