86341

Islet cell (pancreas) antibody measurement

Medicare pricing data for 226 providers across 34 states

🤖AI Overview

This procedure has a 9.8x markup — hospitals charge $225.06 but Medicare allows only $23.04. Uninsured patients may face bills 9.8 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

Islet cell (pancreas) antibody measurement (HCPCS code 86341) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $23.04, but hospitals typically charge $225.06 — a 9.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $23.04, your out-of-pocket cost would be approximately $4.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$23.04
Average Hospital Charge
$225.06
Markup Ratio
9.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$225.06
Medicare Allowed$23.04
Medicare Payment$23.04

Hospitals charge 9.8x more than what Medicare allows for this procedure. Medicare actually pays $23.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$23$25121,328+0.3%
Illinois$23$2796700+0.3%
Indiana$23$189481+0.3%
Kentucky$23$79142+0.3%
Maine$23$254233+0.3%
Maryland$23$2524359+0.3%
New Mexico$23$107137+0.3%
Pennsylvania$23$2676319+0.3%
Rhode Island$23$52116+0.3%
Tennessee$23$1964112+0.3%
Utah$23$737226+0.3%
Puerto Rico$23$24919+0.3%
Alabama$23$2083997+0.3%
Colorado$23$2373315+0.3%
New Jersey$23$24084,142+0.2%
New York$23$144102,029+0.2%
Texas$23$227152,720+0.2%
Florida$23$28083,633+0.1%
Ohio$23$18510896+0.1%
California$23$220224,929+0.1%
Kansas$23$24251,264+0.1%
North Carolina$23$205104,981-0.0%
Oklahoma$23$2184179-0.1%
Arizona$23$20041,041-0.3%
Iowa$23$1843107-0.5%
Nevada$23$2692409-0.5%
Hawaii$23$184295-0.6%
Massachusetts$23$28661,556-0.6%
Virginia$23$1035396-0.7%
Washington$23$1926560-0.7%
Minnesota$23$26691,347-0.8%
Oregon$23$74472-0.9%
Wisconsin$23$1545360-1.4%
Michigan$22$69737-3.0%

⚠️ 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