86039

Measurement of antibody for assessment of autoimmune disorder, titer

Medicare pricing data for 1,279 providers across 43 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 for assessment of autoimmune disorder, titer (HCPCS code 86039) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.92, but hospitals typically charge $54.24 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $10.92, your out-of-pocket cost would be approximately $2.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$10.92
Average Hospital Charge
$54.24
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$54.24
Medicare Allowed$10.92
Medicare Payment$10.92

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $10.92 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$11$523117,215+0.2%
Georgia$11$50410,176+0.2%
Hawaii$11$421709+0.2%
Idaho$11$227111+0.2%
Illinois$11$49185,803+0.2%
Kansas$11$5284,660+0.2%
Maryland$11$5041,611+0.2%
Missouri$11$20667+0.2%
New Hampshire$11$3646130+0.2%
Oregon$11$583182+0.2%
Rhode Island$11$504104+0.2%
Wyoming$11$101115+0.2%
Puerto Rico$11$142542+0.2%
Colorado$11$43472+0.2%
Massachusetts$11$491653,966+0.1%
New Jersey$11$5916819,788+0.1%
New York$11$65336,199+0.1%
Tennessee$11$4831,855+0.1%
Texas$11$6711416,288+0.1%
California$11$497925,220+0.1%
New Mexico$11$5323540.0%
Pennsylvania$11$60143,1780.0%
Utah$11$25105370.0%
Indiana$11$5828406-0.1%
Nevada$11$5022,277-0.1%
North Carolina$11$4322920-0.2%
Iowa$11$4625291-0.3%
Ohio$11$40141,874-0.3%
Oklahoma$11$42122,715-0.3%
Virginia$11$3451,225-0.3%
Kentucky$11$414273-0.4%
South Dakota$11$592313-0.4%
Michigan$11$2910521-0.5%
Arizona$11$5563,772-0.5%
Minnesota$11$792652,167-0.7%
South Carolina$11$3411554-0.9%
Wisconsin$11$87121,034-1.0%
Alabama$11$2512748-1.1%
Arkansas$11$3259323-1.2%
Maine$11$222139-1.7%
Louisiana$11$58964-2.6%
Washington$11$502106-3.1%
Mississippi$8$66921-25.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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