Measurement of antibody to noninfectious agent
Medicare pricing data for 501 providers across 39 states
This procedure has a 6.6x markup — hospitals charge $81.75 but Medicare allows only $12.48. Uninsured patients may face bills 6.6 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 antibody to noninfectious agent (HCPCS code 86256) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.48, but hospitals typically charge $81.75 — a 6.6x 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 $12.48, your out-of-pocket cost would be approximately $2.50. 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 6.6x more than what Medicare allows for this procedure. Medicare actually pays $11.99 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Massachusetts | $18 | $73 | 15 | 2,239 | +46.3% |
| New Hampshire | $18 | $51 | 1 | 41 | +41.7% |
| Arkansas | $16 | $37 | 3 | 54 | +30.4% |
| Iowa | $16 | $79 | 17 | 127 | +28.0% |
| Michigan | $14 | $72 | 13 | 225 | +15.4% |
| Colorado | $14 | $72 | 11 | 373 | +13.5% |
| Illinois | $14 | $121 | 14 | 343 | +9.9% |
| Mississippi | $13 | $104 | 7 | 57 | +7.9% |
| Pennsylvania | $13 | $105 | 14 | 258 | +4.4% |
| Minnesota | $12 | $65 | 13 | 129 | -2.6% |
| New Jersey | $12 | $108 | 17 | 3,407 | -2.7% |
| Texas | $12 | $102 | 40 | 1,507 | -3.2% |
| California | $12 | $65 | 35 | 5,584 | -3.8% |
| Florida | $12 | $77 | 19 | 1,765 | -4.2% |
| Missouri | $12 | $422 | 12 | 106 | -5.0% |
| North Carolina | $12 | $85 | 18 | 3,424 | -5.0% |
| Ohio | $12 | $79 | 9 | 596 | -5.1% |
| Georgia | $12 | $58 | 5 | 194 | -5.4% |
| Hawaii | $12 | $132 | 2 | 19 | -5.4% |
| Indiana | $12 | $98 | 2 | 46 | -5.4% |
| Kansas | $12 | $80 | 4 | 133 | -5.4% |
| Louisiana | $12 | $80 | 2 | 21 | -5.4% |
| New Mexico | $12 | $105 | 3 | 107 | -5.4% |
| New York | $12 | $85 | 15 | 5,819 | -5.4% |
| Rhode Island | $12 | $34 | 1 | 141 | -5.4% |
| Utah | $12 | $38 | 8 | 438 | -5.4% |
| Alabama | $12 | $84 | 4 | 674 | -5.4% |
| Oklahoma | $12 | $116 | 4 | 315 | -5.6% |
| Puerto Rico | $12 | $14 | 104 | 428 | -5.6% |
| Arizona | $12 | $78 | 20 | 691 | -5.6% |
| Washington | $12 | $83 | 5 | 762 | -5.8% |
| Kentucky | $12 | $39 | 2 | 138 | -5.9% |
| Maryland | $12 | $46 | 6 | 184 | -5.9% |
| Oregon | $12 | $46 | 5 | 321 | -5.9% |
| Virginia | $12 | $40 | 5 | 145 | -5.9% |
| Wisconsin | $12 | $139 | 6 | 172 | -7.4% |
| Tennessee | $12 | $97 | 5 | 189 | -7.7% |
| Nevada | $10 | $21 | 2 | 74 | -16.3% |
| South Carolina | $10 | $77 | 6 | 18 | -17.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber