83630

Stool lactoferrin (immune system protein) analysis

Medicare pricing data for 481 providers across 36 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $111.91 but Medicare allows only $19.28. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Stool lactoferrin (immune system protein) analysis (HCPCS code 83630) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.28, but hospitals typically charge $111.91 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.28, your out-of-pocket cost would be approximately $3.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.28
Average Hospital Charge
$111.91
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$111.91
Medicare Allowed$19.28
Medicare Payment$19.28

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $19.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$20$16119728+1.2%
Georgia$19$632579+0.2%
Idaho$19$35427+0.2%
Illinois$19$1416233+0.2%
Indiana$19$111355+0.2%
Iowa$19$88534+0.2%
Kansas$19$107328+0.2%
Louisiana$19$521275+0.2%
Maryland$19$735380+0.2%
Massachusetts$19$1564106+0.2%
Michigan$19$57424+0.2%
Missouri$19$1871124+0.2%
Nevada$19$187137+0.2%
New Mexico$19$108255+0.2%
North Carolina$19$1284767+0.2%
North Dakota$19$881086+0.2%
Pennsylvania$19$180588+0.2%
Utah$19$6133276+0.2%
Puerto Rico$19$22815+0.2%
Texas$19$10553546+0.1%
Arizona$19$1594792+0.1%
California$19$130161,427+0.1%
New Jersey$19$10088090.0%
Ohio$19$7812239-0.1%
Virginia$19$899349-0.1%
New York$19$1048524-0.2%
Oregon$19$5837183-0.2%
Washington$19$12360331-0.3%
Kentucky$19$5530258-0.4%
Hawaii$19$432138-0.5%
Wisconsin$19$968502-0.6%
Tennessee$19$6022236-1.3%
Minnesota$19$5831149-1.4%
South Carolina$19$102557-1.5%
South Dakota$19$108449-1.5%
Oklahoma$18$111533-5.8%

⚠️ 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