81529

Mrna gene analysis of 31 genes in skin melanoma tissue specimen

Medicare pricing data for 2 providers across 1 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

Mrna gene analysis of 31 genes in skin melanoma tissue specimen (HCPCS code 81529) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7,049, but hospitals typically charge $8,500 — a 1.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,410

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7,049, your out-of-pocket cost would be approximately $1,410. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7,049
Average Hospital Charge
$8,500
Markup Ratio
1.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$8,500.00
Medicare Allowed$7,049.14
Medicare Payment$7,049.14

Hospitals charge 1.2x more than what Medicare allows for this procedure. Medicare actually pays $7,049 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$7,049$8,50019,3830.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber