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Immune complex measurement

Medicare pricing data for 96 providers across 19 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Immune complex measurement (HCPCS code 86332) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.78, but hospitals typically charge $84.85 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.78, your out-of-pocket cost would be approximately $4.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$23.78
Average Hospital Charge
$84.85
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$84.85
Medicare Allowed$23.78
Medicare Payment$23.78

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $23.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$24$2275175+0.4%
Georgia$24$544692+0.4%
Illinois$24$188124+0.4%
Kansas$24$181214+0.4%
Maryland$24$190164+0.4%
Massachusetts$24$184388+0.4%
New York$24$63101,292+0.4%
North Carolina$24$1892192+0.4%
Ohio$24$654760+0.4%
Pennsylvania$24$157320+0.4%
Utah$24$49119+0.4%
Washington$24$158319+0.4%
Arizona$24$169225+0.4%
Colorado$24$190212+0.4%
Oregon$24$83316+0.3%
New Jersey$24$2003135+0.2%
Texas$24$667782-0.1%
California$24$81161,726-0.8%
Puerto Rico$24$25726-0.8%

⚠️ 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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