86360

T cell count and ratio, including ratio

Medicare pricing data for 328 providers across 39 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $246.28 but Medicare allows only $45.90. Uninsured patients may face bills 5.4 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

T cell count and ratio, including ratio (HCPCS code 86360) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $45.90, but hospitals typically charge $246.28 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $45.90, your out-of-pocket cost would be approximately $9.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$45.90
Average Hospital Charge
$246.28
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$246.28
Medicare Allowed$45.90
Medicare Payment$45.90

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $45.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$46$1292161+0.3%
Louisiana$46$2942113+0.3%
Maine$46$66388+0.3%
Massachusetts$46$25361,331+0.3%
New Mexico$46$120152+0.3%
North Dakota$46$188433+0.3%
Oklahoma$46$2974248+0.3%
South Carolina$46$94235+0.3%
Utah$46$984183+0.3%
Wisconsin$46$2156179+0.3%
Puerto Rico$46$5128111+0.3%
Colorado$46$2297411+0.3%
Kansas$46$2514322+0.2%
New Jersey$46$2071112,203+0.2%
Ohio$46$23291,331+0.2%
Alabama$46$24741,498+0.2%
Illinois$46$3335875+0.2%
Maryland$46$3097851+0.2%
Texas$46$289264,804+0.2%
Nevada$46$2763398+0.2%
North Carolina$46$27386,766+0.2%
Florida$46$2721111,840+0.1%
New York$46$281111,951+0.1%
Tennessee$46$15212304+0.1%
Pennsylvania$46$2349604+0.0%
Arizona$46$21241,537-0.1%
Indiana$46$1613170-0.2%
California$46$2343010,399-0.4%
Kentucky$46$147297-0.7%
Wyoming$46$79240-0.8%
Connecticut$45$293166-1.1%
Washington$45$2257301-1.3%
Georgia$45$344691-1.3%
Minnesota$45$237471,276-1.3%
Oregon$45$903146-1.4%
Iowa$45$201277-2.2%
Virginia$45$1356133-3.1%
Idaho$44$80119-3.2%
Michigan$44$948125-3.2%

⚠️ 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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