Analysis of substance using immunoassay technique, multiple step method
Medicare pricing data for 2,897 providers across 49 states
This procedure has a 7.3x markup — hospitals charge $82.70 but Medicare allows only $11.27. Uninsured patients may face bills 7.3 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
Analysis of substance using immunoassay technique, multiple step method (HCPCS code 83516) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.27, but hospitals typically charge $82.70 — a 7.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.27, your out-of-pocket cost would be approximately $2.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 7.3x more than what Medicare allows for this procedure. Medicare actually pays $11.27 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Massachusetts | $11 | $74 | 64 | 3,475 | +0.4% |
| Hawaii | $11 | $59 | 7 | 896 | +0.3% |
| Idaho | $11 | $49 | 16 | 104 | +0.3% |
| Maine | $11 | $86 | 3 | 220 | +0.3% |
| Montana | $11 | $35 | 9 | 59 | +0.3% |
| New York | $11 | $89 | 101 | 28,114 | +0.3% |
| Utah | $11 | $36 | 37 | 3,920 | +0.3% |
| Wyoming | $11 | $88 | 2 | 111 | +0.3% |
| Alaska | $11 | $65 | 6 | 140 | +0.3% |
| Georgia | $11 | $46 | 97 | 21,883 | +0.2% |
| Maryland | $11 | $53 | 42 | 23,195 | +0.2% |
| New Jersey | $11 | $122 | 176 | 33,356 | +0.2% |
| New Mexico | $11 | $59 | 11 | 667 | +0.2% |
| North Carolina | $11 | $128 | 75 | 39,220 | +0.2% |
| West Virginia | $11 | $32 | 12 | 1,275 | +0.2% |
| Colorado | $11 | $108 | 28 | 1,814 | +0.2% |
| Connecticut | $11 | $57 | 26 | 1,466 | +0.2% |
| Florida | $11 | $81 | 141 | 26,225 | +0.1% |
| Kansas | $11 | $129 | 30 | 3,931 | +0.1% |
| Mississippi | $11 | $62 | 17 | 1,806 | +0.1% |
| Ohio | $11 | $86 | 172 | 15,221 | +0.1% |
| Pennsylvania | $11 | $38 | 130 | 12,579 | +0.1% |
| Puerto Rico | $11 | $13 | 47 | 160 | +0.1% |
| California | $11 | $99 | 131 | 72,258 | +0.1% |
| Rhode Island | $11 | $38 | 2 | 592 | 0.0% |
| South Carolina | $11 | $41 | 75 | 5,025 | 0.0% |
| South Dakota | $11 | $44 | 27 | 1,158 | 0.0% |
| Missouri | $11 | $87 | 45 | 919 | -0.1% |
| Oregon | $11 | $36 | 33 | 2,240 | -0.1% |
| Tennessee | $11 | $100 | 46 | 2,900 | -0.1% |
| Texas | $11 | $71 | 137 | 51,923 | -0.1% |
| Alabama | $11 | $83 | 56 | 8,534 | -0.1% |
| Arizona | $11 | $89 | 87 | 8,340 | -0.1% |
| Illinois | $11 | $56 | 161 | 6,890 | -0.2% |
| Michigan | $11 | $41 | 41 | 2,174 | -0.2% |
| Minnesota | $11 | $100 | 152 | 11,259 | -0.2% |
| Nebraska | $11 | $38 | 29 | 1,182 | -0.2% |
| New Hampshire | $11 | $35 | 38 | 1,243 | -0.2% |
| Virginia | $11 | $42 | 66 | 4,720 | -0.2% |
| Oklahoma | $11 | $81 | 33 | 2,616 | -0.3% |
| Indiana | $11 | $41 | 136 | 10,001 | -0.4% |
| Kentucky | $11 | $39 | 63 | 4,508 | -0.4% |
| Iowa | $11 | $35 | 29 | 3,064 | -0.4% |
| Wisconsin | $11 | $65 | 33 | 3,469 | -0.4% |
| Louisiana | $11 | $44 | 43 | 1,224 | -0.5% |
| Nevada | $11 | $68 | 7 | 2,469 | -0.5% |
| Arkansas | $11 | $58 | 39 | 1,111 | -1.7% |
| North Dakota | $11 | $47 | 18 | 177 | -3.0% |
| Washington | $11 | $82 | 115 | 6,394 | -3.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber