82553

Creatine kinase (cardiac enzyme) level, mb fraction only

Medicare pricing data for 1,551 providers across 43 states

🤖AI Overview

This procedure has a 6.2x markup — hospitals charge $69.67 but Medicare allows only $11.29. Uninsured patients may face bills 6.2 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

Creatine kinase (cardiac enzyme) level, mb fraction only (HCPCS code 82553) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.29, but hospitals typically charge $69.67 — a 6.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.29, your out-of-pocket cost would be approximately $2.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.29
Average Hospital Charge
$69.67
Markup Ratio
6.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$69.67
Medicare Allowed$11.29
Medicare Payment$11.29

Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $11.29 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kentucky$11$5728110+0.4%
Georgia$11$5537152+0.3%
Hawaii$11$602162+0.3%
Illinois$11$9742332+0.3%
Indiana$11$91540+0.3%
Iowa$11$38637+0.3%
Kansas$11$11828319+0.3%
Maryland$11$911091+0.3%
Minnesota$11$374797+0.3%
Montana$11$51943+0.3%
New Hampshire$11$168122+0.3%
New Jersey$11$101293,569+0.3%
New Mexico$11$134471+0.3%
Ohio$11$11313920+0.3%
Oklahoma$11$558153+0.3%
Rhode Island$11$26458+0.3%
Utah$11$4430118+0.3%
Puerto Rico$11$152242+0.3%
Alaska$11$881040+0.3%
Arizona$11$1378515+0.3%
Florida$11$102691,782+0.2%
Nevada$11$1243151+0.2%
New York$11$59611,622+0.2%
California$11$44918,188+0.2%
Michigan$11$2713481+0.1%
Missouri$11$7749276-0.1%
Washington$11$11327548-0.1%
Nebraska$11$2133519-0.2%
North Carolina$11$1161482,718-0.2%
Tennessee$11$7483890-0.2%
Texas$11$541316,373-0.2%
Massachusetts$11$7616345-0.3%
Pennsylvania$11$4511179-0.3%
Alabama$11$751592,015-0.3%
Louisiana$11$6516171-0.4%
Virginia$11$4156372-0.4%
Oregon$11$4722183-0.5%
Colorado$11$12812208-0.5%
Arkansas$11$3141367-0.8%
South Carolina$11$3649598-0.9%
Mississippi$11$4372498-1.0%
Idaho$11$49940-1.7%
South Dakota$11$541482-1.9%

⚠️ 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

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