81596

Biochemical assays for evaluation of chronic hepatitis c virus infection

Medicare pricing data for 118 providers across 27 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

Biochemical assays for evaluation of chronic hepatitis c virus infection (HCPCS code 81596) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $70.69, but hospitals typically charge $314.51 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.14

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $70.69, your out-of-pocket cost would be approximately $14.14. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$70.69
Average Hospital Charge
$314.51
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$314.51
Medicare Allowed$70.69
Medicare Payment$70.69

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $70.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$71$3081924+0.1%
Hawaii$71$284252+0.1%
Indiana$71$256215+0.1%
Kansas$71$3093343+0.1%
Minnesota$71$3302714+0.1%
Mississippi$71$210217+0.1%
Nevada$71$3091298+0.1%
Ohio$71$3116338+0.1%
Oregon$71$263216+0.1%
Tennessee$71$2264104+0.1%
Virginia$71$3006241+0.1%
Wisconsin$71$149220+0.1%
Alabama$71$326177+0.1%
California$71$312143,431+0.1%
Colorado$71$316378+0.1%
North Carolina$71$32632,439+0.1%
Massachusetts$71$3094900+0.1%
New Jersey$71$31451,989+0.1%
Pennsylvania$71$3044331+0.1%
Texas$71$30381,580+0.0%
New York$71$4135318-0.0%
Florida$71$31061,852-0.1%
Maryland$71$2914184-0.2%
Illinois$71$3103291-0.3%
Washington$70$2893193-0.3%
Arizona$70$3283262-0.6%
Oklahoma$70$3406456-1.0%

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

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