Gene analysis panel for evaluation of genes associated with epilepsy
Medicare pricing data for 36 providers across 8 states
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 panel for evaluation of genes associated with epilepsy (HCPCS code 81419) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,400, but hospitals typically charge $3,241 — a 1.4x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,400, your out-of-pocket cost would be approximately $479.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.4x more than what Medicare allows for this procedure. Medicare actually pays $2,400 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $2,400 | $3,185 | 11 | 1,810 | 0.0% |
| Louisiana | $2,400 | $2,554 | 1 | 52 | 0.0% |
| Maryland | $2,400 | $4,900 | 1 | 14 | 0.0% |
| New Jersey | $2,400 | $3,672 | 2 | 1,302 | 0.0% |
| Oklahoma | $2,400 | $3,421 | 3 | 534 | 0.0% |
| Texas | $2,400 | $2,952 | 15 | 2,247 | 0.0% |
| Arizona | $2,400 | $3,000 | 1 | 44 | 0.0% |
| Colorado | $2,400 | $4,981 | 2 | 69 | 0.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber