86335

Immunologic analysis technique on body fluid, other fluids with concentration

Medicare pricing data for 1,745 providers across 49 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $143.35 but Medicare allows only $24.10. Uninsured patients may face bills 5.9 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

Immunologic analysis technique on body fluid, other fluids with concentration (HCPCS code 86335) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $24.10, but hospitals typically charge $143.35 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.82

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $24.10, your out-of-pocket cost would be approximately $4.82. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$24.10
Average Hospital Charge
$143.35
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$143.35
Medicare Allowed$24.10
Medicare Payment$22.85

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $22.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nevada$29$1822674+19.3%
Puerto Rico$29$3141220+19.1%
Arizona$28$214142,980+17.5%
New Jersey$28$1744019,380+16.1%
North Carolina$27$180388,586+11.4%
Tennessee$26$147171,453+9.2%
Florida$26$16011813,286+7.0%
Georgia$26$151534,339+6.1%
California$25$14713012,458+4.9%
Texas$25$1489418,451+3.9%
Oregon$25$7020439+3.9%
Nebraska$25$6712945+2.0%
Oklahoma$24$12313534+1.1%
Kansas$24$149181,886+0.5%
Maryland$24$176292,719+0.4%
Hawaii$23$698537-2.7%
Colorado$23$15718743-3.7%
Washington$23$118261,359-4.1%
Alabama$23$140353,046-4.2%
South Dakota$23$9822184-4.4%
New York$23$169614,859-6.3%
Minnesota$22$1361742,101-7.2%
Ohio$22$114976,724-10.7%
Wisconsin$22$160471,819-10.8%
Virginia$21$97242,209-12.0%
Rhode Island$21$589240-12.6%
Louisiana$21$16514266-12.9%
Massachusetts$21$122536,384-13.3%
Maine$21$776773-14.5%
Mississippi$20$14913247-15.9%
Pennsylvania$20$104765,183-16.2%
Illinois$20$134954,669-16.4%
Iowa$20$83581,220-18.8%
North Dakota$19$11310276-19.1%
Kentucky$19$6916243-19.5%
Connecticut$19$118151,252-22.2%
District of Columbia$19$64366-22.5%
Indiana$19$8231686-22.8%
Utah$19$7221769-23.2%
Michigan$18$85702,996-23.7%
Missouri$18$73401,218-25.7%
Delaware$18$83237-26.8%
Montana$18$48214-27.0%
South Carolina$17$749174-27.6%
Idaho$17$3616287-28.4%
New Hampshire$17$1494114-28.4%
West Virginia$17$76437-28.6%
Vermont$17$913588-29.0%
Arkansas$17$38151,979-31.5%

⚠️ 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

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