84146

Prolactin (milk producing hormone) level

Medicare pricing data for 3,377 providers across 48 states

🤖AI Overview

This procedure has a 5.5x markup — hospitals charge $103.55 but Medicare allows only $18.94. Uninsured patients may face bills 5.5 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

Prolactin (milk producing hormone) level (HCPCS code 84146) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $18.94, but hospitals typically charge $103.55 — a 5.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $18.94, your out-of-pocket cost would be approximately $3.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$18.94
Average Hospital Charge
$103.55
Markup Ratio
5.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$103.55
Medicare Allowed$18.94
Medicare Payment$18.94

Hospitals charge 5.5x more than what Medicare allows for this procedure. Medicare actually pays $18.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$19$27128+0.3%
Iowa$19$7453266+0.3%
Nebraska$19$378155+0.3%
Nevada$19$148171,125+0.3%
New Hampshire$19$781838+0.3%
North Dakota$19$5282,117+0.3%
Florida$19$11715017,141+0.2%
Massachusetts$19$1391483,604+0.2%
Georgia$19$147732,575+0.2%
Kansas$19$158222,830+0.2%
Missouri$19$199301,058+0.2%
New Jersey$19$1298722,281+0.2%
Pennsylvania$19$111222,238+0.2%
Arizona$19$666623,487+0.2%
New Mexico$19$1166306+0.1%
California$19$9216329,219+0.1%
Colorado$19$12943972+0.1%
Texas$19$11230715,593+0.1%
Puerto Rico$19$21117346+0.1%
Maryland$19$118302,0410.0%
South Carolina$19$64181,0970.0%
North Carolina$19$12312412,126-0.1%
Ohio$19$106814,504-0.1%
Rhode Island$19$687306-0.1%
Michigan$19$4744888-0.1%
New York$19$9547714,315-0.1%
Indiana$19$8651440-0.3%
Alabama$19$111533,590-0.3%
Louisiana$19$55561,614-0.4%
Washington$19$1091002,185-0.4%
Illinois$19$1351342,701-0.4%
Oregon$19$5738581-0.4%
Oklahoma$19$10925829-0.5%
Utah$19$4070572-0.5%
Minnesota$19$1111661,039-0.7%
Virginia$19$5680982-0.7%
Tennessee$19$652232,481-0.8%
Arkansas$19$8054604-0.8%
Hawaii$19$742466-0.9%
Kentucky$19$6349470-1.1%
Mississippi$19$7222311-1.1%
Maine$19$6212106-1.2%
Wisconsin$19$13137929-1.3%
South Dakota$19$11012161-1.6%
Connecticut$19$8329186-2.0%
West Virginia$19$1081055-2.1%
Idaho$18$711994-2.5%
Alaska$18$41565-5.0%

⚠️ 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