84160

Total protein level

Medicare pricing data for 61 providers across 11 states

🤖AI Overview

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

Total protein level (HCPCS code 84160) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.48, but hospitals typically charge $24.04 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.48, your out-of-pocket cost would be approximately $1.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.48
Average Hospital Charge
$24.04
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$24.04
Medicare Allowed$5.48
Medicare Payment$5.48

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $5.48 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$6$24780+0.4%
New Jersey$6$9217+0.4%
New York$6$35151+0.4%
North Carolina$6$9154+0.4%
Wisconsin$6$131280+0.4%
Puerto Rico$6$71761+0.4%
Alabama$6$202124+0.4%
California$6$761,660+0.4%
Oregon$5$1326210.0%
Tennessee$5$3414,1130.0%
Texas$5$2615100-7.5%

⚠️ 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