81286

Gene analysis (frataxin) of full sequence

Medicare pricing data for 33 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 (frataxin) of full sequence (HCPCS code 81286) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $269.24, but hospitals typically charge $299.76 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$53.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $269.24, your out-of-pocket cost would be approximately $53.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$269.24
Average Hospital Charge
$299.76
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$299.76
Medicare Allowed$269.24
Medicare Payment$269.24

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $269.24 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$269$279158+0.0%
New Jersey$269$33522,914+0.0%
Oklahoma$269$3383257+0.0%
Pennsylvania$269$27511,058+0.0%
Texas$269$278136,176+0.0%
Arizona$269$3001119+0.0%
Colorado$269$1,172112+0.0%
Florida$269$32910995-0.1%
Maryland$251$520134-7.0%

⚠️ 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