86141

Measurement c-reactive protein for detection of infection or inflammation, high sensitivity

Medicare pricing data for 3,034 providers across 47 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 c-reactive protein for detection of infection or inflammation, high sensitivity (HCPCS code 86141) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.67, but hospitals typically charge $61.86 — a 4.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.67, your out-of-pocket cost would be approximately $2.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.67
Average Hospital Charge
$61.86
Markup Ratio
4.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$61.86
Medicare Allowed$12.67
Medicare Payment$12.67

Hospitals charge 4.9x more than what Medicare allows for this procedure. Medicare actually pays $12.67 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$13$262298+0.2%
Idaho$13$599176+0.2%
Kentucky$13$3021302+0.2%
Maine$13$6012132+0.2%
Missouri$13$121471,395+0.2%
New Hampshire$13$56729+0.2%
North Dakota$13$3441,476+0.2%
Rhode Island$13$396585+0.2%
South Dakota$13$67462+0.2%
West Virginia$13$355245+0.2%
Wyoming$13$80314+0.2%
Colorado$13$67191,347+0.2%
Connecticut$13$5024100+0.2%
Illinois$13$5410718,399+0.1%
Massachusetts$13$3616433,780+0.1%
Nevada$13$68115,590+0.1%
North Carolina$13$718020,614+0.1%
Texas$13$609414,475+0.1%
California$13$57335119,741+0.1%
New Jersey$13$798030,7530.0%
New Mexico$13$9832180.0%
New York$13$7958951,7910.0%
Oklahoma$13$54151,0010.0%
Washington$13$61855,3610.0%
Georgia$13$66196,153-0.1%
Indiana$13$55521,950-0.1%
Arizona$13$578726,118-0.1%
Florida$13$6414253,412-0.2%
Hawaii$13$4022,181-0.2%
Kansas$13$67277,231-0.2%
Maryland$13$66173,090-0.2%
Virginia$13$54481,478-0.2%
Puerto Rico$13$141691,041-0.2%
Alabama$13$60303,986-0.2%
Iowa$13$529462-0.2%
Michigan$13$33653,376-0.2%
Minnesota$13$791511,754-0.2%
Louisiana$13$6429309-0.3%
Ohio$13$858125,812-0.3%
Tennessee$13$56731,760-0.3%
Pennsylvania$13$28223,123-0.4%
Utah$13$281242,820-0.5%
Wisconsin$13$8919864-0.6%
Oregon$13$46562,118-0.8%
South Carolina$13$27292,712-0.9%
Arkansas$13$2316240-0.9%
Nebraska$13$46163,489-1.2%

⚠️ 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