85390

Coagulation function screening test with interpretation and report

Medicare pricing data for 644 providers across 34 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

Coagulation function screening test with interpretation and report (HCPCS code 85390) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.67, but hospitals typically charge $101.21 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.93

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.67, your out-of-pocket cost would be approximately $6.93. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.67
Average Hospital Charge
$101.21
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$101.21
Medicare Allowed$34.67
Medicare Payment$27.13

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $27.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$38$151223,921+9.7%
New Jersey$38$7015347+9.7%
Connecticut$38$83191,827+8.5%
California$37$10641842+7.5%
Oregon$37$10912217+6.3%
Maryland$36$172418+5.1%
New York$36$110282,753+4.1%
Hawaii$36$868207+4.1%
Pennsylvania$36$10824622+4.0%
New Hampshire$36$2003107+2.4%
Illinois$35$69371,765+2.1%
Michigan$35$9429630+2.1%
Georgia$35$1203127+1.6%
Vermont$35$824228+0.8%
Washington$35$8618916+0.3%
Florida$35$8838888-0.2%
Maine$35$89324-0.3%
Texas$34$82801,448-0.9%
Ohio$34$8533715-1.7%
Nebraska$34$923496-1.8%
Indiana$34$10915189-2.0%
Mississippi$34$606115-2.4%
Arkansas$34$753182-3.1%
Alabama$33$556155-4.2%
Nevada$33$81121,383-4.2%
Missouri$32$59567-6.3%
Tennessee$32$557413-7.2%
North Carolina$32$806477-8.9%
New Mexico$31$15611278-10.8%
Iowa$28$6520347-19.6%
Oklahoma$25$568132-27.0%
Minnesota$25$131531,015-29.0%
Arizona$23$11113135-33.3%
Wisconsin$19$7010394-44.4%

⚠️ 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