Gene analysis (prothrombin, coagulation factor ii) a variant
Medicare pricing data for 102 providers across 12 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 (prothrombin, coagulation factor ii) a variant (HCPCS code 81240) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $64.31, but hospitals typically charge $189.95 — a 3.0x 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 $64.31, your out-of-pocket cost would be approximately $12.86. 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 3.0x more than what Medicare allows for this procedure. Medicare actually pays $64.31 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $64 | $212 | 3 | 102 | +0.1% |
| New Mexico | $64 | $365 | 1 | 29 | +0.1% |
| North Carolina | $64 | $349 | 3 | 16 | +0.1% |
| Ohio | $64 | $293 | 4 | 14 | +0.1% |
| Oklahoma | $64 | $316 | 4 | 66 | +0.1% |
| Virginia | $64 | $213 | 3 | 31 | +0.1% |
| Arizona | $64 | $292 | 2 | 17 | +0.1% |
| New Jersey | $64 | $372 | 7 | 1,407 | +0.1% |
| Colorado | $64 | $311 | 6 | 301 | +0.0% |
| Texas | $64 | $234 | 17 | 846 | +0.0% |
| Florida | $64 | $120 | 23 | 5,080 | -0.0% |
| Pennsylvania | $64 | $270 | 7 | 77 | -0.1% |
⚠️ 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