86359

T cells count, total

Medicare pricing data for 269 providers across 35 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

T cells count, total (HCPCS code 86359) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $36.86, but hospitals typically charge $151.80 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $36.86, your out-of-pocket cost would be approximately $7.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$36.86
Average Hospital Charge
$151.80
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$151.80
Medicare Allowed$36.86
Medicare Payment$36.86

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $36.86 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kansas$37$1804614+0.3%
Maine$37$56389+0.3%
Maryland$37$1346331+0.3%
Massachusetts$37$1395920+0.3%
New Mexico$37$97153+0.3%
North Dakota$37$165433+0.3%
South Dakota$37$220124+0.3%
Utah$37$815192+0.3%
Wisconsin$37$1935181+0.3%
Wyoming$37$65138+0.3%
Puerto Rico$37$40615+0.3%
Alabama$37$1834392+0.3%
New Jersey$37$128108,585+0.3%
Ohio$37$1419553+0.3%
Florida$37$170116,305+0.3%
Colorado$37$1805416+0.3%
Texas$37$146191,629+0.2%
New York$37$21281,941+0.1%
North Carolina$37$16482,227+0.1%
Tennessee$37$9012282+0.1%
Hawaii$37$1002261+0.1%
Illinois$37$1625414+0.1%
Arizona$37$13139720.0%
Nevada$37$1372206-0.0%
Pennsylvania$37$1476492-0.0%
Georgia$37$182150-0.1%
Oklahoma$37$1794408-0.5%
California$37$150296,882-0.5%
Indiana$37$1402174-0.7%
Minnesota$37$185471,301-0.9%
Oregon$36$874164-1.2%
Michigan$36$62465-1.7%
Virginia$36$1105112-2.0%
Washington$36$1557159-2.4%
Iowa$35$110123-4.3%

⚠️ 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