81338

Gene analysis (mpl proto-oncogene, thrombopoietin receptor) for detection of common variants

Medicare pricing data for 190 providers across 21 states

🤖AI Overview

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 (mpl proto-oncogene, thrombopoietin receptor) for detection of common variants (HCPCS code 81338) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $141.91, but hospitals typically charge $492.25 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $141.91, your out-of-pocket cost would be approximately $28.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$141.91
Average Hospital Charge
$492.25
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$492.25
Medicare Allowed$141.91
Medicare Payment$141.91

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $141.91 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$147$340188+3.8%
Illinois$147$2421429+3.8%
Louisiana$147$2282116+3.8%
Minnesota$147$479711+3.8%
Missouri$147$602124+3.8%
New Mexico$147$538140+3.8%
North Carolina$147$6642115+3.8%
Oklahoma$147$245121+3.8%
Utah$147$3011134+3.8%
Wisconsin$147$502236+3.8%
Arizona$147$6792924+3.8%
Arkansas$147$230274+3.8%
California$147$604425+3.8%
Colorado$147$633212+3.8%
Connecticut$147$4562278+3.6%
New York$147$669801,001+3.5%
New Jersey$147$51351,264+3.5%
Florida$146$39414731+3.1%
Washington$146$475767+2.9%
Michigan$144$3851634+1.4%
Texas$111$2268810-22.1%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber