85385

Fibrinogen (factor 1) antigen detection

Medicare pricing data for 101 providers across 21 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

Fibrinogen (factor 1) antigen detection (HCPCS code 85385) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.17, but hospitals typically charge $48.92 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.17, your out-of-pocket cost would be approximately $2.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.17
Average Hospital Charge
$48.92
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$48.92
Medicare Allowed$14.17
Medicare Payment$14.17

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $14.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$14$541493+0.4%
Florida$14$6967230.0%
Georgia$14$5411630.0%
Kansas$14$7021640.0%
Maryland$14$531140.0%
Nevada$14$5321340.0%
New Jersey$14$9554290.0%
New York$14$693760.0%
Ohio$14$6072,9170.0%
Pennsylvania$14$432180.0%
Tennessee$14$4118570.0%
Texas$14$7362980.0%
Utah$14$352140.0%
Washington$14$10632760.0%
Puerto Rico$14$145170.0%
Alabama$14$1813440.0%
Arizona$14$15232890.0%
Colorado$14$1333220.0%
Massachusetts$14$23410,442-0.1%
North Carolina$14$1663944-0.1%
California$14$7510989-0.1%

⚠️ 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