81256

Gene analysis (hemochromatosis) common variants

Medicare pricing data for 225 providers across 32 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 (hemochromatosis) common variants (HCPCS code 81256) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $64.02, but hospitals typically charge $264.11 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $64.02, your out-of-pocket cost would be approximately $12.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$64.02
Average Hospital Charge
$264.11
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$264.11
Medicare Allowed$64.02
Medicare Payment$64.02

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $64.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$64$510298+0.0%
Indiana$64$384425+0.0%
Iowa$64$270343+0.0%
Louisiana$64$83581+0.0%
Massachusetts$64$5424221+0.0%
Michigan$64$259613+0.0%
Minnesota$64$65527288+0.0%
Nevada$64$5521101+0.0%
New Mexico$64$938119+0.0%
New York$64$4524188+0.0%
Ohio$64$33610330+0.0%
Oklahoma$64$2048411+0.0%
Pennsylvania$64$12271,227+0.0%
South Carolina$64$131112+0.0%
Tennessee$64$2034306+0.0%
Utah$64$1352496+0.0%
Virginia$64$4344272+0.0%
Washington$64$3395223+0.0%
Wisconsin$64$570527+0.0%
Alabama$64$2702249+0.0%
Arizona$64$3925825+0.0%
California$64$452121,476+0.0%
Colorado$64$38610280+0.0%
Texas$64$1003010,582+0.0%
North Carolina$64$30064,3550.0%
New Jersey$64$377135,553-0.0%
Florida$64$335182,652-0.1%
Georgia$64$5272601-0.2%
Kansas$64$5223295-0.2%
Maryland$63$5024155-0.8%
Oregon$63$236484-0.9%
Hawaii$63$186251-1.4%

⚠️ 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