86356

White blood cell antigen measurement

Medicare pricing data for 117 providers across 22 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

White blood cell antigen measurement (HCPCS code 86356) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $26.19, but hospitals typically charge $123.78 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.24

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $26.19, your out-of-pocket cost would be approximately $5.24. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$26.19
Average Hospital Charge
$123.78
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$123.78
Medicare Allowed$26.19
Medicare Payment$26.19

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $26.19 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$26$15551,060+0.2%
Georgia$26$155172+0.2%
Illinois$26$1672106+0.2%
Kansas$26$1983152+0.2%
Maryland$26$2212205+0.2%
Massachusetts$26$210478+0.2%
North Carolina$26$886907+0.2%
Ohio$26$1665271+0.2%
Oklahoma$26$119384+0.2%
Tennessee$26$42522+0.2%
Texas$26$877589+0.2%
Virginia$26$72255+0.2%
Wisconsin$26$211217+0.2%
Alabama$26$1233509+0.2%
Colorado$26$1315141+0.2%
Minnesota$26$1444954+0.2%
Arizona$26$8531,365+0.2%
New Jersey$26$11341,866+0.1%
Washington$26$764291+0.1%
New York$26$1894164-0.4%
California$26$16913792-1.0%
Utah$26$76583-1.9%

⚠️ 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