84585

Urine vanillylmandelic acid

Medicare pricing data for 126 providers across 25 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

Urine vanillylmandelic acid (HCPCS code 84585) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $15.18, but hospitals typically charge $66.54 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.04

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $15.18, your out-of-pocket cost would be approximately $3.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$15.18
Average Hospital Charge
$66.54
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$66.54
Medicare Allowed$15.18
Medicare Payment$15.18

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $15.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$15$1284314+0.1%
Georgia$15$1311128+0.1%
Illinois$15$131344+0.1%
Iowa$15$76419+0.1%
Kansas$15$130564+0.1%
Kentucky$15$162696+0.1%
Maryland$15$124331+0.1%
Massachusetts$15$1334112+0.1%
Minnesota$15$110514+0.1%
Nevada$15$128126+0.1%
Ohio$15$77753+0.1%
Oklahoma$15$139326+0.1%
Oregon$15$21380+0.1%
Pennsylvania$15$125434+0.1%
Tennessee$15$73141+0.1%
Texas$15$1166221+0.1%
Utah$15$32221+0.1%
Virginia$15$30431+0.1%
Washington$15$112319+0.1%
Arizona$15$1163121+0.1%
North Carolina$15$5656,2090.0%
New York$15$119998-0.1%
New Jersey$15$1225262-0.2%
California$15$12612319-0.5%
Alabama$15$74440-1.6%

⚠️ 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