Protein s (clotting inhibitor) level
Medicare pricing data for 131 providers across 26 states
This procedure has a 16.3x markup — hospitals charge $185.66 but Medicare allows only $11.36. Uninsured patients may face bills 16.3 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Protein s (clotting inhibitor) level (HCPCS code 85305) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.36, but hospitals typically charge $185.66 — a 16.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.36, your out-of-pocket cost would be approximately $2.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 16.3x more than what Medicare allows for this procedure. Medicare actually pays $11.36 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $11 | $230 | 1 | 232 | +0.2% |
| Illinois | $11 | $231 | 3 | 85 | +0.2% |
| Indiana | $11 | $240 | 2 | 12 | +0.2% |
| Maryland | $11 | $216 | 2 | 183 | +0.2% |
| Massachusetts | $11 | $237 | 2 | 79 | +0.2% |
| Minnesota | $11 | $160 | 5 | 25 | +0.2% |
| Nevada | $11 | $218 | 2 | 77 | +0.2% |
| Oklahoma | $11 | $248 | 3 | 31 | +0.2% |
| Pennsylvania | $11 | $198 | 5 | 54 | +0.2% |
| Tennessee | $11 | $186 | 4 | 24 | +0.2% |
| Utah | $11 | $31 | 3 | 33 | +0.2% |
| Washington | $11 | $193 | 3 | 30 | +0.2% |
| Wisconsin | $11 | $145 | 2 | 15 | +0.2% |
| Alabama | $11 | $157 | 2 | 84 | +0.2% |
| Colorado | $11 | $196 | 4 | 173 | +0.2% |
| Florida | $11 | $225 | 6 | 651 | +0.1% |
| North Carolina | $11 | $180 | 5 | 1,747 | +0.1% |
| Texas | $11 | $120 | 10 | 817 | +0.1% |
| Arizona | $11 | $206 | 5 | 1,045 | +0.1% |
| New Jersey | $11 | $203 | 7 | 1,687 | 0.0% |
| New York | $11 | $67 | 6 | 256 | -0.2% |
| California | $11 | $210 | 13 | 501 | -0.2% |
| Ohio | $11 | $105 | 8 | 128 | -0.6% |
| Kansas | $11 | $209 | 3 | 70 | -1.8% |
| Hawaii | $11 | $118 | 2 | 12 | -4.4% |
| Virginia | $11 | $49 | 3 | 30 | -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.
💊 Need post-procedure medications? Check costs on OpenPrescriber