Test for detecting genes associated with breast cancer
Medicare pricing data for 6 providers across 1 states
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
Test for detecting genes associated with breast cancer (HCPCS code 81519) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,779, but hospitals typically charge $4,619 — a 1.2x 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 $3,779, your out-of-pocket cost would be approximately $755.83. 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 1.2x more than what Medicare allows for this procedure. Medicare actually pays $3,779 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $3,780 | $4,620 | 1 | 25,048 | +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