82104

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

Medicare pricing data for 173 providers across 34 states

🤖AI Overview

This procedure has a 9.9x markup — hospitals charge $140.45 but Medicare allows only $14.13. Uninsured patients may face bills 9.9 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, phenotype (HCPCS code 82104) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.13, but hospitals typically charge $140.45 — a 9.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.13, your out-of-pocket cost would be approximately $2.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.13
Average Hospital Charge
$140.45
Markup Ratio
9.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$140.45
Medicare Allowed$14.13
Medicare Payment$14.13

Hospitals charge 9.9x more than what Medicare allows for this procedure. Medicare actually pays $14.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$14$1792502+0.3%
Hawaii$14$123223+0.3%
Indiana$14$152122+0.3%
Iowa$14$46423+0.3%
Kansas$14$1585510+0.3%
Maryland$14$1464165+0.3%
Massachusetts$14$1773218+0.3%
Missouri$14$306244+0.3%
Nevada$14$1692122+0.3%
New Mexico$14$56150+0.3%
New York$14$1256321+0.3%
Oklahoma$14$1354133+0.3%
Oregon$14$39341+0.3%
Rhode Island$14$34112+0.3%
South Carolina$14$167333+0.3%
South Dakota$14$125244+0.3%
Tennessee$14$91377+0.3%
Texas$14$145101,240+0.3%
Utah$14$314171+0.3%
Virginia$14$705123+0.3%
Alabama$14$1123471+0.3%
Colorado$14$122495+0.3%
North Carolina$14$10871,944+0.2%
New Jersey$14$137101,089+0.1%
Arizona$14$1543699+0.1%
Florida$14$17561,691+0.1%
Illinois$14$2534211-0.1%
Ohio$14$10411468-0.1%
Pennsylvania$14$1386120-0.5%
Minnesota$14$1575218-0.6%
Wisconsin$14$1335138-1.0%
Washington$14$1316191-1.1%
Puerto Rico$14$15611-1.2%
California$14$145171,104-1.6%

⚠️ 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