81320

Gene analysis (phospholipase c gamma 2) for common variants

Medicare pricing data for 35 providers across 5 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 (phospholipase c gamma 2) for common variants (HCPCS code 81320) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $285.51, but hospitals typically charge $312.38 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$57.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $285.51, your out-of-pocket cost would be approximately $57.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$285.51
Average Hospital Charge
$312.38
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$312.38
Medicare Allowed$285.51
Medicare Payment$285.51

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $285.51 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$286$3122414,764+0.0%
Louisiana$286$352117+0.0%
New Jersey$286$296330+0.0%
Pennsylvania$286$291230+0.0%
Texas$269$302516-5.8%

⚠️ 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