81291

Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants

Medicare pricing data for 154 providers across 14 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 (5, 10-methylenetetrahydrofolate reductase) common variants (HCPCS code 81291) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $63.93, but hospitals typically charge $125.71 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $63.93, your out-of-pocket cost would be approximately $12.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$63.93
Average Hospital Charge
$125.71
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$125.71
Medicare Allowed$63.93
Medicare Payment$63.93

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $63.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$64$333455+0.2%
Mississippi$64$973129+0.2%
New Mexico$64$275113+0.2%
Ohio$64$4664162+0.2%
Oklahoma$64$1447219+0.2%
Arizona$64$201361+0.2%
Arkansas$64$131128+0.2%
Colorado$64$3493131+0.2%
Texas$64$100528,630+0.1%
Florida$64$115235,010+0.1%
Pennsylvania$64$13910388-0.1%
Virginia$64$983268-0.5%
New Jersey$64$190152,701-0.6%
Louisiana$63$103792-2.0%

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

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