Gene analysis (colorectal cancer)
Medicare pricing data for 17 providers across 3 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
Gene analysis (colorectal cancer) (HCPCS code 81528) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $498.52, but hospitals typically charge $680.52 — 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 $498.52, your out-of-pocket cost would be approximately $99.70. 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 $498.52 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $499 | $657 | 1 | 310 | +0.0% |
| Minnesota | $499 | $585 | 2 | 2,917 | +0.0% |
| Wisconsin | $499 | $681 | 10 | 600,436 | 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