82103

Alpha-1-antitrypsin (protein) blood test, total

Medicare pricing data for 423 providers across 42 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $94.26 but Medicare allows only $13.13. Uninsured patients may face bills 7.2 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

Alpha-1-antitrypsin (protein) blood test, total (HCPCS code 82103) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.13, but hospitals typically charge $94.26 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.13, your out-of-pocket cost would be approximately $2.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$13.13
Average Hospital Charge
$94.26
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$94.26
Medicare Allowed$13.13
Medicare Payment$13.13

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $13.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$13$11011,169+0.3%
Indiana$13$127362+0.3%
Kentucky$13$512138+0.3%
Massachusetts$13$926941+0.3%
Missouri$13$350444+0.3%
Nevada$13$1102332+0.3%
New Hampshire$13$481114+0.3%
New Mexico$13$54187+0.3%
North Dakota$13$53215+0.3%
Rhode Island$13$40154+0.3%
South Dakota$13$108560+0.3%
Utah$13$278261+0.3%
Puerto Rico$13$142849+0.3%
Colorado$13$914291+0.3%
Connecticut$13$69216+0.3%
Florida$13$107133,719+0.2%
Kansas$13$11171,304+0.2%
Maryland$13$817604+0.2%
New York$13$108281,459+0.2%
North Carolina$13$92126,170+0.2%
Alabama$13$9051,490+0.2%
Arizona$13$9041,977+0.2%
Illinois$13$10560615+0.2%
Pennsylvania$13$9210566+0.2%
Texas$13$96254,118+0.2%
Tennessee$13$903255+0.1%
Minnesota$13$148138420.0%
New Jersey$13$108424,123-0.1%
Ohio$13$74151,725-0.1%
Oklahoma$13$5761,886-0.1%
Virginia$13$376435-0.1%
Hawaii$13$862181-0.2%
Washington$13$8614842-0.2%
Louisiana$13$79213-0.4%
South Carolina$13$547144-0.4%
Maine$13$47282-0.8%
Iowa$13$645146-0.8%
California$13$92264,068-1.0%
Wisconsin$13$1079408-1.4%
Mississippi$13$190469-3.0%
Oregon$13$474186-4.4%
Michigan$13$51792-4.8%

⚠️ 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