85041

Red blood cell count, automated test

Medicare pricing data for 217 providers across 26 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

Red blood cell count, automated test (HCPCS code 85041) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2.94, but hospitals typically charge $12.73 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2.94, your out-of-pocket cost would be approximately $0.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2.94
Average Hospital Charge
$12.73
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$12.73
Medicare Allowed$2.94
Medicare Payment$2.94

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $2.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$3$112468+0.7%
Illinois$3$106216+0.7%
Kansas$3$103267+0.7%
Louisiana$3$7425+0.7%
Maryland$3$105393+0.7%
Massachusetts$3$124230+0.7%
Minnesota$3$111925+0.7%
Missouri$3$5397+0.7%
Nevada$3$132139+0.7%
Oregon$3$29231+0.7%
Pennsylvania$3$15791+0.7%
Virginia$3$33528+0.7%
Washington$3$29564+0.7%
Wisconsin$3$10245+0.7%
Puerto Rico$3$45254+0.7%
Florida$3$10101,348+0.3%
New Jersey$3$1173,223+0.3%
New York$3$76427+0.3%
Texas$3$1511609+0.3%
California$3$15291,776+0.3%
North Carolina$3$2641,4070.0%
Ohio$3$139736-0.7%
Colorado$3$16377-0.7%
Arizona$3$631,378-2.4%
Alabama$3$1833209-2.7%
Arkansas$3$5471-7.1%

⚠️ 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