Clotting factor x assessment test, diluted
Medicare pricing data for 325 providers across 36 states
This procedure has a 10.4x markup — hospitals charge $97.87 but Medicare allows only $9.37. Uninsured patients may face bills 10.4 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
Clotting factor x assessment test, diluted (HCPCS code 85613) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.37, but hospitals typically charge $97.87 — a 10.4x 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 $9.37, your out-of-pocket cost would be approximately $1.87. 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 10.4x more than what Medicare allows for this procedure. Medicare actually pays $9.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $9 | $91 | 13 | 3,477 | +0.2% |
| Georgia | $9 | $89 | 2 | 1,211 | +0.2% |
| Iowa | $9 | $53 | 4 | 126 | +0.2% |
| Massachusetts | $9 | $91 | 7 | 631 | +0.2% |
| Michigan | $9 | $46 | 4 | 42 | +0.2% |
| Nevada | $9 | $111 | 1 | 346 | +0.2% |
| New Mexico | $9 | $137 | 2 | 141 | +0.2% |
| Oregon | $9 | $33 | 4 | 69 | +0.2% |
| Pennsylvania | $9 | $112 | 9 | 461 | +0.2% |
| South Carolina | $9 | $32 | 2 | 17 | +0.2% |
| South Dakota | $9 | $43 | 2 | 28 | +0.2% |
| Tennessee | $9 | $62 | 3 | 493 | +0.2% |
| Utah | $9 | $21 | 4 | 224 | +0.2% |
| Puerto Rico | $9 | $11 | 12 | 42 | +0.2% |
| Connecticut | $9 | $95 | 2 | 34 | +0.2% |
| Kansas | $9 | $86 | 6 | 628 | +0.1% |
| Minnesota | $9 | $99 | 68 | 950 | +0.1% |
| New Jersey | $9 | $88 | 10 | 11,820 | +0.1% |
| North Carolina | $9 | $121 | 9 | 11,358 | +0.1% |
| Arizona | $9 | $114 | 5 | 5,878 | +0.1% |
| Colorado | $9 | $72 | 6 | 1,218 | +0.1% |
| New York | $9 | $203 | 23 | 1,624 | 0.0% |
| Oklahoma | $9 | $67 | 5 | 525 | 0.0% |
| Alabama | $9 | $67 | 5 | 388 | 0.0% |
| California | $9 | $84 | 20 | 4,670 | 0.0% |
| Maryland | $9 | $73 | 6 | 505 | -0.1% |
| Texas | $9 | $74 | 22 | 4,456 | -0.1% |
| Wisconsin | $9 | $111 | 7 | 527 | -0.3% |
| Illinois | $9 | $84 | 10 | 725 | -1.0% |
| Virginia | $9 | $36 | 4 | 221 | -1.0% |
| Hawaii | $9 | $21 | 2 | 235 | -1.1% |
| Kentucky | $9 | $31 | 2 | 58 | -1.2% |
| Indiana | $9 | $28 | 2 | 43 | -1.7% |
| Washington | $9 | $59 | 5 | 345 | -1.8% |
| Ohio | $9 | $58 | 11 | 625 | -2.1% |
| Maine | $9 | $26 | 2 | 89 | -3.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber