81325

Gene analysis (peripheral myelin protein 22), full sequence analysis

Medicare pricing data for 40 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 (peripheral myelin protein 22), full sequence analysis (HCPCS code 81325) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $753.97, but hospitals typically charge $841.92 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$150.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $753.97, your out-of-pocket cost would be approximately $150.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$753.97
Average Hospital Charge
$841.92
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$841.92
Medicare Allowed$753.97
Medicare Payment$753.97

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $753.97 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$754$860263+0.0%
New Jersey$754$94032,981+0.0%
Oklahoma$754$9293286+0.0%
Pennsylvania$754$77211,102+0.0%
Arizona$754$1,000160+0.0%
Colorado$754$3,336113+0.0%
Texas$754$782176,216+0.0%
Florida$751$98310593-0.3%
Maryland$730$1,020126-3.2%

⚠️ 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