81542

Mrna gene expression analysis of 22 genes in prostate tumor tissue

Medicare pricing data for 3 providers across 1 states

🤖AI Overview

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 expression analysis of 22 genes in prostate tumor tissue (HCPCS code 81542) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,789, but hospitals typically charge $5,151 — a 1.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$757.73

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3,789, your out-of-pocket cost would be approximately $757.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3,789
Average Hospital Charge
$5,151
Markup Ratio
1.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,150.68
Medicare Allowed$3,788.63
Medicare Payment$3,788.63

Hospitals charge 1.4x more than what Medicare allows for this procedure. Medicare actually pays $3,789 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$3,789$5,150118,9300.0%

⚠️ 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