85004

White blood cell count

Medicare pricing data for 383 providers across 33 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

White blood cell count (HCPCS code 85004) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.30, but hospitals typically charge $27.93 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.30, your out-of-pocket cost would be approximately $1.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.30
Average Hospital Charge
$27.93
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$27.93
Medicare Allowed$6.30
Medicare Payment$6.30

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $6.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$6$30141,955+0.6%
Georgia$6$194310+0.6%
Illinois$6$18101,019+0.6%
Iowa$6$2622388+0.6%
Kansas$6$185378+0.6%
Maryland$6$29369+0.6%
Massachusetts$6$29183,060+0.6%
Michigan$6$72455+0.6%
Missouri$6$135208+0.6%
Nevada$6$193509+0.6%
New Hampshire$6$241178+0.6%
North Dakota$6$335104+0.6%
Oklahoma$6$22359+0.6%
Pennsylvania$6$156985+0.6%
Virginia$6$20417+0.6%
Arkansas$6$12459+0.6%
Colorado$6$1641,027+0.6%
New Jersey$6$2681,211+0.5%
Texas$6$2710889+0.5%
California$6$2118889+0.5%
Puerto Rico$6$86217+0.3%
South Dakota$6$26311,481+0.2%
Tennessee$6$87192+0.2%
Mississippi$6$50333,7630.0%
Washington$6$2316128-0.2%
Indiana$6$502121-0.3%
Minnesota$6$4174793-0.8%
North Carolina$6$213490-0.8%
Ohio$6$247149-1.1%
Arizona$6$1131,326-2.5%
Alabama$6$23398-3.7%
New York$6$94238-4.1%
Wisconsin$6$4731599-6.5%

⚠️ 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