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Immunologic analysis technique on serum

Medicare pricing data for 165 providers across 18 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

Immunologic analysis technique on serum (HCPCS code 86320) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $22.71, but hospitals typically charge $98.65 — a 4.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.54

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $22.71, your out-of-pocket cost would be approximately $4.54. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$22.71
Average Hospital Charge
$98.65
Markup Ratio
4.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$98.65
Medicare Allowed$22.71
Medicare Payment$20.13

Hospitals charge 4.3x more than what Medicare allows for this procedure. Medicare actually pays $20.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Oregon$29$108123+29.1%
Puerto Rico$29$3028255+29.1%
Arizona$29$156111,568+28.7%
Texas$29$108702,154+28.6%
Ohio$23$5892,759-0.1%
New York$22$9324,547-2.2%
California$21$57253-8.3%
Colorado$20$605191-12.2%
Connecticut$19$684537-15.2%
Massachusetts$19$10358,133-17.2%
Illinois$18$473107-21.1%
Florida$17$4551,141-24.0%
Virginia$17$60231-24.0%
Michigan$17$5061,267-25.3%
Tennessee$17$4084,568-25.8%
North Carolina$17$4012,266-25.8%
Missouri$17$69481-26.0%
Alabama$15$46112-32.1%

⚠️ 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