81241

Gene analysis (coagulation factor v) leiden variant

Medicare pricing data for 129 providers across 13 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 (coagulation factor v) leiden variant (HCPCS code 81241) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $71.85, but hospitals typically charge $132.88 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $71.85, your out-of-pocket cost would be approximately $14.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$71.85
Average Hospital Charge
$132.88
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$132.88
Medicare Allowed$71.85
Medicare Payment$71.85

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $71.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$72$2723101+0.1%
New Mexico$72$367132+0.1%
North Carolina$72$331324+0.1%
Ohio$72$286751+0.1%
Oklahoma$72$375462+0.1%
Pennsylvania$72$2819106+0.1%
Virginia$72$268338+0.1%
Puerto Rico$72$74619+0.1%
Arizona$72$266222+0.1%
Colorado$72$3096281+0.1%
Florida$72$1083418,504+0.0%
Texas$72$28323916-0.1%
New Jersey$72$27891,385-0.2%

⚠️ 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