82085

Aldolase (enzyme) level

Medicare pricing data for 338 providers across 40 states

🤖AI Overview

This procedure has a 7.7x markup — hospitals charge $72.81 but Medicare allows only $9.45. Uninsured patients may face bills 7.7 times higher than what insurance negotiates. 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

Aldolase (enzyme) level (HCPCS code 82085) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.45, but hospitals typically charge $72.81 — a 7.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.89

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.45, your out-of-pocket cost would be approximately $1.89. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$9.45
Average Hospital Charge
$72.81
Markup Ratio
7.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$72.81
Medicare Allowed$9.45
Medicare Payment$9.45

Hospitals charge 7.7x more than what Medicare allows for this procedure. Medicare actually pays $9.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$10$8032,006+0.7%
Illinois$10$7991,248+0.7%
Kansas$10$7151,473+0.7%
Louisiana$10$57418+0.7%
Maryland$10$847534+0.7%
Massachusetts$10$6481,062+0.7%
Nevada$10$742353+0.7%
New Hampshire$10$33524+0.7%
New Mexico$10$86190+0.7%
Rhode Island$10$36130+0.7%
South Dakota$10$53326+0.7%
Puerto Rico$10$1057154+0.7%
Colorado$10$838294+0.7%
Connecticut$10$66233+0.7%
Florida$10$78124,729+0.6%
New York$10$12891,646+0.6%
North Carolina$10$75127,658+0.6%
Ohio$10$67141,876+0.6%
New Jersey$10$76127,637+0.5%
Alabama$10$7161,905+0.5%
Arizona$10$6542,421+0.5%
Pennsylvania$9$708544+0.4%
Hawaii$9$442402+0.3%
Texas$9$70215,864+0.3%
Iowa$9$515141+0.2%
Washington$9$697679+0.2%
South Carolina$9$284152+0.1%
Tennessee$9$786429+0.1%
Utah$9$196725+0.1%
Kentucky$9$374940.0%
Oklahoma$9$5963420.0%
Minnesota$9$9311931-0.2%
Virginia$9$348383-0.2%
Maine$9$27155-0.6%
Indiana$9$833125-0.7%
Oregon$9$383122-1.4%
Wisconsin$9$739242-1.5%
California$9$67235,772-3.4%
Mississippi$9$46819-7.6%
Michigan$6$306120-34.3%

⚠️ 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