86308

Screening test for mononucleosis (mono)

Medicare pricing data for 4,957 providers across 51 states

🤖AI Overview

This procedure has a 7.0x markup — hospitals charge $35.51 but Medicare allows only $5.04. Uninsured patients may face bills 7.0 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

Screening test for mononucleosis (mono) (HCPCS code 86308) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.04, but hospitals typically charge $35.51 — a 7.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.01

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.04, your out-of-pocket cost would be approximately $1.01. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.04
Average Hospital Charge
$35.51
Markup Ratio
7.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$35.51
Medicare Allowed$5.04
Medicare Payment$5.04

Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $5.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$5$361314+0.8%
Florida$5$261991,605+0.8%
Hawaii$5$20636+0.8%
Kansas$5$4661286+0.8%
Maine$5$261528+0.8%
Maryland$5$3899234+0.8%
Montana$5$261519+0.8%
Nebraska$5$245279+0.8%
New Hampshire$5$334147+0.8%
New Mexico$5$292034+0.8%
North Dakota$5$322236+0.8%
South Dakota$5$341831+0.8%
Utah$5$155062+0.8%
Vermont$5$281113+0.8%
Wyoming$5$321419+0.8%
Puerto Rico$5$62060+0.8%
Alaska$5$551314+0.8%
California$5$352751,081+0.8%
Massachusetts$5$38178467+0.6%
New Jersey$5$561091,573+0.6%
New York$5$272481,783+0.6%
Rhode Island$5$211332+0.6%
Idaho$5$231618+0.4%
Minnesota$5$26220272+0.4%
Pennsylvania$5$40113266+0.4%
North Carolina$5$48217791+0.2%
Texas$5$45255960+0.2%
South Carolina$5$301361740.0%
Georgia$5$41152281-0.2%
Louisiana$5$2390246-0.2%
Mississippi$5$27172334-0.2%
Ohio$5$42130356-0.2%
Arizona$5$4159302-0.2%
Kentucky$5$25115168-0.4%
Michigan$5$27114164-0.4%
Colorado$5$4065152-0.4%
Wisconsin$5$5490190-0.6%
Missouri$5$3592115-0.8%
Tennessee$5$23256472-0.8%
Arkansas$5$18106145-1.0%
Illinois$5$41155305-1.2%
Oklahoma$5$3171131-1.2%
Virginia$5$28188280-1.2%
Indiana$5$26131190-1.4%
Oregon$5$254279-1.4%
Alabama$5$29185561-1.4%
Nevada$5$342140-1.8%
Washington$5$37107253-2.0%
Connecticut$5$353256-2.2%
Iowa$5$2696138-3.2%
West Virginia$5$353642-3.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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