85055

Reticulated (young) platelet measurement

Medicare pricing data for 829 providers across 24 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

Reticulated (young) platelet measurement (HCPCS code 85055) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.88, but hospitals typically charge $129.33 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.88, your out-of-pocket cost would be approximately $6.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.88
Average Hospital Charge
$129.33
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$129.33
Medicare Allowed$34.88
Medicare Payment$34.88

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $34.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$35$155462+0.4%
Iowa$35$114635+0.4%
Nebraska$35$79729+0.4%
North Carolina$35$95989+0.4%
Ohio$35$393357+0.4%
Oregon$35$1331460+0.4%
Pennsylvania$35$757178+0.4%
Virginia$35$13917688+0.4%
Wisconsin$35$136449+0.4%
Arizona$35$471213+0.4%
Connecticut$35$2678571+0.4%
Oklahoma$35$89292,464+0.2%
Illinois$35$102241,427+0.2%
Michigan$35$9024676+0.2%
Texas$35$14351024,1880.0%
Alabama$35$80174220.0%
New York$35$77473,201-0.1%
Maryland$35$1388156-0.1%
New Mexico$35$528126-0.4%
Colorado$35$137432,720-0.4%
California$35$586153-0.7%
Georgia$34$125525-2.0%
Missouri$34$546734-2.5%
Washington$33$110623-4.4%

⚠️ 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