Measurement of complement (immune system proteins), antigen,
Medicare pricing data for 1,834 providers across 49 states
This procedure has a 7.2x markup — hospitals charge $84.01 but Medicare allows only $11.72. Uninsured patients may face bills 7.2 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
Measurement of complement (immune system proteins), antigen, (HCPCS code 86160) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.72, but hospitals typically charge $84.01 — a 7.2x 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 $11.72, your out-of-pocket cost would be approximately $2.34. 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 7.2x more than what Medicare allows for this procedure. Medicare actually pays $11.72 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Idaho | $12 | $34 | 12 | 426 | +0.3% |
| Rhode Island | $12 | $40 | 2 | 172 | +0.3% |
| South Dakota | $12 | $65 | 7 | 618 | +0.3% |
| Utah | $12 | $27 | 8 | 392 | +0.3% |
| Wyoming | $12 | $90 | 6 | 70 | +0.3% |
| Alaska | $12 | $58 | 4 | 19 | +0.3% |
| Florida | $12 | $105 | 72 | 44,362 | +0.3% |
| Kansas | $12 | $109 | 16 | 9,039 | +0.3% |
| New Mexico | $12 | $55 | 5 | 1,414 | +0.3% |
| New York | $12 | $90 | 83 | 24,393 | +0.3% |
| Georgia | $12 | $89 | 60 | 16,207 | +0.2% |
| Massachusetts | $12 | $103 | 62 | 6,417 | +0.2% |
| Nevada | $12 | $118 | 4 | 2,749 | +0.2% |
| New Jersey | $12 | $94 | 73 | 57,177 | +0.2% |
| Puerto Rico | $12 | $13 | 118 | 631 | +0.2% |
| California | $12 | $75 | 127 | 92,052 | +0.2% |
| Colorado | $12 | $97 | 9 | 2,814 | +0.2% |
| Hawaii | $12 | $44 | 2 | 3,258 | +0.1% |
| Virginia | $12 | $22 | 21 | 16,089 | +0.1% |
| North Carolina | $12 | $104 | 117 | 46,951 | 0.0% |
| Texas | $12 | $87 | 130 | 52,457 | 0.0% |
| Arizona | $12 | $84 | 44 | 15,385 | 0.0% |
| New Hampshire | $12 | $40 | 8 | 198 | -0.1% |
| Ohio | $12 | $71 | 78 | 16,922 | -0.1% |
| Oregon | $12 | $46 | 8 | 1,405 | -0.1% |
| Pennsylvania | $12 | $89 | 20 | 6,913 | -0.1% |
| Illinois | $12 | $93 | 81 | 8,669 | -0.2% |
| Louisiana | $12 | $66 | 27 | 1,568 | -0.2% |
| Kentucky | $12 | $39 | 27 | 1,077 | -0.3% |
| Michigan | $12 | $39 | 16 | 1,404 | -0.3% |
| Alabama | $12 | $77 | 27 | 12,549 | -0.3% |
| Tennessee | $12 | $77 | 54 | 4,994 | -0.3% |
| Washington | $12 | $63 | 88 | 7,000 | -0.4% |
| Connecticut | $12 | $128 | 3 | 195 | -0.4% |
| Indiana | $12 | $66 | 24 | 1,382 | -0.5% |
| Missouri | $12 | $40 | 26 | 2,164 | -0.5% |
| South Carolina | $12 | $51 | 29 | 2,322 | -0.5% |
| Arkansas | $12 | $31 | 26 | 1,968 | -0.5% |
| Maryland | $12 | $61 | 42 | 7,208 | -0.6% |
| Oklahoma | $12 | $81 | 34 | 4,885 | -0.6% |
| District of Columbia | $12 | $41 | 6 | 379 | -0.7% |
| Montana | $12 | $29 | 2 | 373 | -0.9% |
| Nebraska | $12 | $45 | 8 | 1,415 | -0.9% |
| Minnesota | $12 | $87 | 118 | 4,028 | -0.9% |
| Iowa | $12 | $42 | 35 | 1,658 | -1.4% |
| Mississippi | $12 | $87 | 13 | 1,131 | -1.4% |
| Wisconsin | $12 | $106 | 29 | 3,744 | -1.5% |
| Maine | $12 | $29 | 9 | 497 | -1.9% |
| North Dakota | $11 | $74 | 8 | 400 | -4.4% |
⚠️ 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