83631

Stool lactoferrin (immune system protein) level

Medicare pricing data for 90 providers across 23 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $111.43 but Medicare allows only $19.23. Uninsured patients may face bills 5.8 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

Stool lactoferrin (immune system protein) level (HCPCS code 83631) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.23, but hospitals typically charge $111.43 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.23, your out-of-pocket cost would be approximately $3.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.23
Average Hospital Charge
$111.43
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$111.43
Medicare Allowed$19.23
Medicare Payment$19.23

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $19.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$19$24281,026+0.1%
Georgia$19$2322120+0.1%
Illinois$19$612267+0.1%
Kansas$19$270296+0.1%
Louisiana$19$163215+0.1%
Maryland$19$265221+0.1%
Massachusetts$19$2803129+0.1%
New York$19$935174+0.1%
Ohio$19$1565195+0.1%
Oklahoma$19$262236+0.1%
Pennsylvania$19$280214+0.1%
Texas$19$2096293+0.1%
Virginia$19$1844287+0.1%
Washington$19$1673355+0.1%
Wisconsin$19$93314+0.1%
Alabama$19$1623254+0.1%
Arizona$19$1893653+0.1%
California$19$2536150+0.1%
Colorado$19$204313+0.1%
New Jersey$19$4886,7700.0%
North Carolina$19$16332,6260.0%
Arkansas$19$391445-0.2%
Tennessee$19$342237-0.7%

⚠️ 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