86001

Measurement of antibody (igg) to allergic substance, each allergen

Medicare pricing data for 64 providers across 8 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

Measurement of antibody (igg) to allergic substance, each allergen (HCPCS code 86001) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.16, but hospitals typically charge $14.01 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.23

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6.16, your out-of-pocket cost would be approximately $1.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6.16
Average Hospital Charge
$14.01
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$14.01
Medicare Allowed$6.16
Medicare Payment$6.16

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $6.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$8$13414,056+24.4%
Ohio$8$170894+24.4%
Tennessee$8$2035,872+24.4%
Washington$8$33449+24.4%
Nevada$8$371554+24.2%
California$8$38103,399+24.2%
Arizona$7$423687+21.3%
North Carolina$4$5617,111-35.4%

⚠️ 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