86340

Intrinsic factor (stomach protein) antibody measurement

Medicare pricing data for 269 providers across 34 states

🤖AI Overview

This procedure has a 8.9x markup — hospitals charge $131.60 but Medicare allows only $14.75. Uninsured patients may face bills 8.9 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

Intrinsic factor (stomach protein) antibody measurement (HCPCS code 86340) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.75, but hospitals typically charge $131.60 — a 8.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.75, your out-of-pocket cost would be approximately $2.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.75
Average Hospital Charge
$131.60
Markup Ratio
8.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$131.60
Medicare Allowed$14.75
Medicare Payment$14.75

Hospitals charge 8.9x more than what Medicare allows for this procedure. Medicare actually pays $14.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$15$1433373+0.2%
Hawaii$15$76256+0.2%
Indiana$15$77376+0.2%
Iowa$15$48619+0.2%
Kansas$15$1364160+0.2%
Kentucky$15$48211+0.2%
Maine$15$101156+0.2%
Maryland$15$1256275+0.2%
Nevada$15$131277+0.2%
New Hampshire$15$66616+0.2%
New Jersey$15$158112,210+0.2%
New Mexico$15$98153+0.2%
Ohio$15$13010350+0.2%
Oklahoma$15$108349+0.2%
Oregon$15$50436+0.2%
Pennsylvania$15$1106133+0.2%
Tennessee$15$69284+0.2%
Texas$15$100151,049+0.2%
Wisconsin$15$129576+0.2%
Alabama$15$1364154+0.2%
Colorado$15$139595+0.2%
Florida$15$148121,234+0.1%
Illinois$15$12313183+0.1%
California$15$128241,436+0.1%
Massachusetts$15$13053770.0%
Minnesota$15$20534300.0%
New York$15$115111,4070.0%
North Carolina$15$141123,0100.0%
Arizona$15$1264701-0.1%
Puerto Rico$15$173859-0.3%
Utah$15$324161-0.9%
Virginia$15$384113-1.3%
Washington$14$1258171-2.4%
Michigan$14$467122-5.5%

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

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