84681

C-peptide (protein) level

Medicare pricing data for 1,185 providers across 45 states

🤖AI Overview

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

C-peptide (protein) level (HCPCS code 84681) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.34, but hospitals typically charge $87.32 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.07

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.34, your out-of-pocket cost would be approximately $4.07. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$20.34
Average Hospital Charge
$87.32
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$87.32
Medicare Allowed$20.34
Medicare Payment$20.34

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $20.34 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Idaho$20$9315241+0.2%
Indiana$20$1039537+0.2%
Iowa$20$52698+0.2%
Kansas$20$8093,230+0.2%
Louisiana$20$9813248+0.2%
Maine$20$47246+0.2%
Maryland$20$7372,058+0.2%
Missouri$20$459172+0.2%
New Hampshire$20$83936+0.2%
New Mexico$20$713101+0.2%
North Dakota$20$59590+0.2%
Pennsylvania$20$5771,273+0.2%
Rhode Island$20$57145+0.2%
Colorado$20$1208797+0.2%
Florida$20$6611225,374+0.2%
Illinois$20$72512,823+0.2%
Massachusetts$20$4478,285+0.2%
Nevada$20$7241,214+0.2%
Washington$20$8671,933+0.2%
Georgia$20$75205,872+0.1%
New Jersey$20$858618,927+0.1%
Ohio$20$1364811,038+0.1%
California$20$798815,760+0.1%
New York$20$1095614,956-0.1%
Puerto Rico$20$2571153-0.1%
North Carolina$20$112358,911-0.1%
Texas$20$956313,895-0.1%
South Dakota$20$99498-0.2%
Utah$20$3627205-0.2%
Oklahoma$20$123101,047-0.2%
South Carolina$20$55221,224-0.3%
Arizona$20$105156,403-0.3%
Hawaii$20$712207-0.3%
Kentucky$20$66161,864-0.3%
Tennessee$20$941112,327-0.5%
Alabama$20$107344,612-0.6%
Minnesota$20$16396604-0.6%
Oregon$20$676304-1.3%
Mississippi$20$7818195-1.4%
Virginia$20$40181,655-1.6%
Wisconsin$20$10311513-1.6%
Arkansas$20$4714104-1.8%
Nebraska$20$88346-1.9%
Alaska$19$136529-4.5%
Michigan$19$5215226-5.6%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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