Gene analysis (muts homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis
Medicare pricing data for 62 providers across 8 states
This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 (muts homolog 2, colon cancer, nonpolyposis type 1) full sequence analysis (HCPCS code 81295) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $373.75, but hospitals typically charge $481.75 — a 1.3x 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 $373.75, your out-of-pocket cost would be approximately $74.75. 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 1.3x more than what Medicare allows for this procedure. Medicare actually pays $373.75 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $374 | $384 | 2 | 40 | +0.1% |
| New York | $374 | $1,081 | 2 | 12 | +0.1% |
| Oklahoma | $374 | $573 | 1 | 32 | +0.1% |
| Pennsylvania | $374 | $382 | 2 | 1,011 | +0.1% |
| Florida | $374 | $508 | 23 | 2,706 | +0.1% |
| Maryland | $374 | $955 | 3 | 163 | +0.0% |
| New Jersey | $374 | $459 | 13 | 2,349 | -0.0% |
| Texas | $372 | $475 | 14 | 280 | -0.6% |
⚠️ 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