86331

Immunologic analysis for detection of antigen or antibody

Medicare pricing data for 233 providers across 31 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 for detection of antigen or antibody (HCPCS code 86331) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.66, but hospitals typically charge $50.80 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.66, your out-of-pocket cost would be approximately $2.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.66
Average Hospital Charge
$50.80
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$50.80
Medicare Allowed$11.66
Medicare Payment$11.66

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $11.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$12$6551,180+0.7%
Georgia$12$441184+0.7%
Hawaii$12$65216+0.7%
Illinois$12$41276+0.7%
Kansas$12$56588+0.7%
Kentucky$12$411150+0.7%
Maine$12$727112+0.7%
Maryland$12$434293+0.7%
Massachusetts$12$473106+0.7%
Missouri$12$33144+0.7%
Nevada$12$38158+0.7%
New York$12$455648+0.7%
Oklahoma$12$524120+0.7%
Pennsylvania$12$376141+0.7%
Tennessee$12$322143+0.7%
Texas$12$40121,666+0.7%
Wisconsin$12$1243395+0.7%
Alabama$12$90289+0.7%
Colorado$12$79449+0.7%
Utah$12$212450+0.4%
New Jersey$12$565902+0.3%
North Carolina$12$8541,908+0.3%
California$12$30194,792+0.3%
Minnesota$12$775946+0.2%
Arizona$12$49889950.0%
Washington$12$734291-1.4%
South Dakota$11$49228-2.4%
Ohio$11$489278-6.1%
Virginia$11$176100-7.9%
Oregon$10$19366-15.0%
Iowa$8$8171-33.3%

⚠️ 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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