86226

Measurement of dna antibody, single stranded

Medicare pricing data for 359 providers across 29 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 dna antibody, single stranded (HCPCS code 86226) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.77, but hospitals typically charge $50.17 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.77, your out-of-pocket cost would be approximately $2.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.77
Average Hospital Charge
$50.17
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$50.17
Medicare Allowed$11.77
Medicare Payment$11.77

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $11.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$12$526456+0.8%
New York$12$466462+0.8%
Ohio$12$18687+0.8%
Tennessee$12$20422+0.8%
Washington$12$256170+0.8%
California$12$42172,318+0.8%
Virginia$12$256267+0.5%
Georgia$12$11326917+0.4%
Oregon$12$362196+0.4%
South Carolina$12$4620534+0.4%
Florida$12$44181,332+0.3%
Illinois$12$121181,486+0.3%
North Carolina$12$4044872+0.2%
Pennsylvania$12$3918367+0.2%
Iowa$12$2751110.0%
Kansas$12$5582030.0%
Maryland$12$27155420.0%
New Mexico$12$3422540.0%
Missouri$12$422698-0.1%
Minnesota$12$4013256-0.2%
Idaho$12$665228-0.3%
Kentucky$12$3612626-0.3%
Indiana$12$4234242-0.6%
Texas$12$31213,528-0.6%
Louisiana$12$831248-0.9%
Alabama$12$1413195-0.9%
Arkansas$12$6011755-1.0%
Nebraska$12$436356-1.6%
Oklahoma$11$69255-2.8%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber