81546

Mrna gene analysis of 10,196 genes in fine needle aspiration thyroid specimen, reported as category result (e.g. benign, suspicious)

Medicare pricing data for 1 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 10,196 genes in fine needle aspiration thyroid specimen, reported as category result (e.g. benign, suspicious) (HCPCS code 81546) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,509, but hospitals typically charge $6,400 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$701.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3,509, your out-of-pocket cost would be approximately $701.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3,509
Average Hospital Charge
$6,400
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$6,400.00
Medicare Allowed$3,508.51
Medicare Payment$3,508.51

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $3,509 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$3,509$6,40019,2730.0%

⚠️ 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