86355

Total cell count for b cells (white blood cells)

Medicare pricing data for 230 providers across 32 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

Total cell count for b cells (white blood cells) (HCPCS code 86355) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.90, but hospitals typically charge $140.91 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.90, your out-of-pocket cost would be approximately $7.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.90
Average Hospital Charge
$140.91
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$140.91
Medicare Allowed$36.90
Medicare Payment$36.90

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $36.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$37$116267+0.2%
Indiana$37$170212+0.2%
Kansas$37$1584420+0.2%
Maine$37$107238+0.2%
Maryland$37$1255282+0.2%
Michigan$37$104515+0.2%
New Mexico$37$101155+0.2%
North Dakota$37$170433+0.2%
Oklahoma$37$1454103+0.2%
Oregon$37$154315+0.2%
Utah$37$100539+0.2%
Wisconsin$37$212496+0.2%
Alabama$37$170382+0.2%
New Jersey$37$11196,858+0.2%
Arizona$37$1243607+0.2%
Colorado$37$1814382+0.2%
Florida$37$145102,388+0.1%
Texas$37$129151,124+0.1%
Ohio$37$1717185+0.1%
California$37$124153,455+0.0%
North Carolina$37$16171,4930.0%
Pennsylvania$37$1326321-0.0%
Illinois$37$1303298-0.2%
Massachusetts$37$1136677-0.2%
Nevada$37$1191164-0.2%
New York$37$27361,067-0.3%
Minnesota$37$236441,255-0.4%
Georgia$37$138128-0.5%
Tennessee$37$731176-0.6%
Washington$36$1476136-2.7%
Iowa$36$120226-3.3%
Virginia$36$1094193-3.3%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber