81305

Gene analysis (myeloid differentiation primary response 88) for p.leu265pro variant

Medicare pricing data for 90 providers across 11 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 (myeloid differentiation primary response 88) for p.leu265pro variant (HCPCS code 81305) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $171.83, but hospitals typically charge $228.51 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$34.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $171.83, your out-of-pocket cost would be approximately $34.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$171.83
Average Hospital Charge
$228.51
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$228.51
Medicare Allowed$171.83
Medicare Payment$171.83

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $171.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Pennsylvania$172$175218+0.0%
Tennessee$172$4242130+0.0%
Utah$172$353243+0.0%
Washington$172$4156128+0.0%
Arizona$172$4382323+0.0%
Florida$172$2002413,154+0.0%
California$172$3965867-0.0%
New Jersey$171$590792-0.6%
Connecticut$170$611269-1.2%
Texas$170$4141037-1.2%
Minnesota$168$669247-2.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber