85046

Red blood count automated, with additional calculations

Medicare pricing data for 1,537 providers across 38 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 count automated, with additional calculations (HCPCS code 85046) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.44, but hospitals typically charge $23.81 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.09

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.44, your out-of-pocket cost would be approximately $1.09. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.44
Average Hospital Charge
$23.81
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$23.81
Medicare Allowed$5.44
Medicare Payment$5.44

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $5.44 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$6$201044+4.2%
Florida$5$2123911,279+0.4%
Kansas$5$1913376+0.4%
Louisiana$5$104181+0.4%
Massachusetts$5$252058+0.4%
New Mexico$5$292644+0.4%
South Dakota$5$349163+0.4%
Arizona$5$323371+0.4%
Colorado$5$211496+0.4%
Connecticut$5$556135+0.4%
Minnesota$5$30802,414+0.2%
New York$5$26745,506+0.2%
North Carolina$5$29731,198+0.2%
California$5$205113,993+0.2%
Maine$5$17182530.0%
Michigan$5$15334610.0%
Missouri$5$27463580.0%
Virginia$5$29744,4750.0%
Iowa$5$2052978-0.2%
Kentucky$5$343123-0.2%
Ohio$5$1515692-0.2%
Oregon$5$2150363-0.2%
Tennessee$5$2852693-0.2%
Texas$5$283267,636-0.2%
New Jersey$5$194105-0.4%
Utah$5$95101-0.4%
Alabama$5$18426,624-0.4%
Washington$5$15531,482-0.6%
Indiana$5$3721291-0.7%
North Dakota$5$254264-0.7%
Arkansas$5$17231,187-0.7%
Wisconsin$5$52241,509-0.9%
Alaska$5$461790-0.9%
Illinois$5$3124998-1.1%
Pennsylvania$5$32202,817-1.1%
Nebraska$5$1421351-1.3%
Mississippi$5$25542-6.3%
Nevada$5$11133-11.8%

⚠️ 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

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