81309

Gene analysis (partner and localizer of brca2) targeted sequence analysis

Medicare pricing data for 52 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 (partner and localizer of brca2) targeted sequence analysis (HCPCS code 81309) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $269.32, but hospitals typically charge $300.30 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$53.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $269.32, your out-of-pocket cost would be approximately $53.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$269.32
Average Hospital Charge
$300.30
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$300.30
Medicare Allowed$269.32
Medicare Payment$269.32

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $269.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$269$2,651222+0.0%
Louisiana$269$299243+0.0%
New Jersey$269$33343,014+0.0%
Oklahoma$269$3463303+0.0%
Pennsylvania$269$27522,125+0.0%
Texas$269$281159,344+0.0%
Arizona$269$300179+0.0%
Colorado$269$1,191113+0.0%
Florida$269$343131,110-0.1%

⚠️ 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