81251

Gene analysis (glucosidase, beta, acid) common variants

Medicare pricing data for 42 providers across 8 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 (glucosidase, beta, acid) common variants (HCPCS code 81251) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $46.30, but hospitals typically charge $55.03 — a 1.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $46.30, your out-of-pocket cost would be approximately $9.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$46.30
Average Hospital Charge
$55.03
Markup Ratio
1.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$55.03
Medicare Allowed$46.30
Medicare Payment$46.30

Hospitals charge 1.2x more than what Medicare allows for this procedure. Medicare actually pays $46.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$46$73128250.0%
Louisiana$46$562630.0%
Oklahoma$46$7632440.0%
Pennsylvania$46$4711,1060.0%
Texas$46$50146,1080.0%
Arizona$46$1001600.0%
Colorado$46$2051130.0%
New Jersey$46$6083,059-0.0%

⚠️ 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