81250

Gene analysis (glucose-6-phosphatase, catalytic subunit) common variants

Medicare pricing data for 56 providers across 9 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 (glucose-6-phosphatase, catalytic subunit) common variants (HCPCS code 81250) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $57.32, but hospitals typically charge $70.88 — a 1.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $57.32, your out-of-pocket cost would be approximately $11.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$57.32
Average Hospital Charge
$70.88
Markup Ratio
1.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$70.88
Medicare Allowed$57.32
Medicare Payment$57.32

Hospitals charge 1.2x more than what Medicare allows for this procedure. Medicare actually pays $57.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$57$761910,7230.0%
Louisiana$57$8621250.0%
Mississippi$57$1751110.0%
New Jersey$57$6855,5940.0%
Oklahoma$57$632980.0%
Pennsylvania$57$5923,2310.0%
Texas$57$69229,1640.0%
Arizona$57$751590.0%
Colorado$57$2382930.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber