86148

Phospholipid antibody (autoimmune antibody) measurement

Medicare pricing data for 98 providers across 16 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

Phospholipid antibody (autoimmune antibody) measurement (HCPCS code 86148) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $15.66, but hospitals typically charge $77.57 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.13

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $15.66, your out-of-pocket cost would be approximately $3.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$15.66
Average Hospital Charge
$77.57
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$77.57
Medicare Allowed$15.66
Medicare Payment$15.66

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $15.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$16$1222102+0.6%
Idaho$16$996107+0.6%
Minnesota$16$1382156+0.6%
New York$16$1236905+0.6%
Tennessee$16$104256+0.6%
Washington$16$126273+0.6%
Alabama$16$1132199+0.6%
Colorado$16$1183376+0.6%
North Carolina$16$13182,783+0.5%
California$16$501312,039+0.3%
Ohio$16$1054428-0.1%
Arizona$16$7231,742-0.2%
New Jersey$16$10962,768-1.0%
Hawaii$15$154266-2.0%
Texas$15$866349-2.4%
Virginia$14$28237-10.3%

⚠️ 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