Gene analysis (hexosaminidase a) common variants
Medicare pricing data for 37 providers across 8 states
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 (hexosaminidase a) common variants (HCPCS code 81255) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $50.42, but hospitals typically charge $58.61 — a 1.2x 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 $50.42, your out-of-pocket cost would be approximately $10.08. 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 1.2x more than what Medicare allows for this procedure. Medicare actually pays $50.42 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $50 | $69 | 10 | 596 | 0.0% |
| Louisiana | $50 | $60 | 2 | 63 | 0.0% |
| Oklahoma | $50 | $82 | 3 | 245 | 0.0% |
| Pennsylvania | $50 | $52 | 1 | 1,107 | 0.0% |
| Texas | $50 | $55 | 13 | 6,192 | 0.0% |
| Arizona | $50 | $75 | 1 | 60 | 0.0% |
| Colorado | $50 | $240 | 2 | 14 | 0.0% |
| New Jersey | $50 | $63 | 5 | 2,973 | -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.
💊 Need post-procedure medications? Check costs on OpenPrescriber