Mrna gene analysis of 11 genes in breast tumor tissue
Medicare pricing data for 1 providers across 1 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
Mrna gene analysis of 11 genes in breast tumor tissue (HCPCS code 81518) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,785, but hospitals typically charge $5,399 — 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 $3,785, your out-of-pocket cost would be approximately $756.96. 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 $3,785 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $3,785 | $5,399 | 1 | 9,049 | 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