Phospholipid test
Medicare pricing data for 145 providers across 26 states
This procedure has a 7.8x markup — hospitals charge $137.14 but Medicare allows only $17.55. Uninsured patients may face bills 7.8 times higher than what insurance negotiates. 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
Phospholipid test (HCPCS code 85598) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.55, but hospitals typically charge $137.14 — a 7.8x 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 $17.55, your out-of-pocket cost would be approximately $3.51. 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 7.8x more than what Medicare allows for this procedure. Medicare actually pays $17.55 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Hawaii | $18 | $136 | 2 | 40 | +0.4% |
| Illinois | $18 | $149 | 4 | 173 | +0.4% |
| Massachusetts | $18 | $143 | 4 | 162 | +0.4% |
| Minnesota | $18 | $243 | 10 | 78 | +0.4% |
| Nevada | $18 | $156 | 1 | 89 | +0.4% |
| South Dakota | $18 | $90 | 1 | 21 | +0.4% |
| Tennessee | $18 | $71 | 4 | 93 | +0.4% |
| Utah | $18 | $43 | 2 | 24 | +0.4% |
| Alabama | $18 | $123 | 2 | 212 | +0.4% |
| Arizona | $18 | $149 | 4 | 1,038 | +0.3% |
| California | $18 | $139 | 14 | 1,190 | +0.3% |
| Colorado | $18 | $129 | 5 | 760 | +0.2% |
| Georgia | $18 | $155 | 1 | 384 | +0.1% |
| Wisconsin | $18 | $113 | 3 | 112 | +0.1% |
| Kansas | $18 | $153 | 5 | 183 | +0.1% |
| North Carolina | $18 | $149 | 8 | 2,613 | +0.1% |
| Texas | $18 | $94 | 9 | 1,892 | +0.1% |
| New Jersey | $18 | $143 | 5 | 4,401 | -0.1% |
| New York | $17 | $113 | 6 | 193 | -0.3% |
| Pennsylvania | $17 | $139 | 6 | 138 | -0.3% |
| Washington | $17 | $126 | 3 | 115 | -0.4% |
| Florida | $17 | $154 | 7 | 1,221 | -0.5% |
| Maryland | $17 | $138 | 4 | 164 | -0.9% |
| Virginia | $17 | $97 | 5 | 40 | -1.3% |
| Ohio | $17 | $130 | 7 | 197 | -1.3% |
| Oklahoma | $17 | $128 | 3 | 113 | -2.6% |
⚠️ 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