T cell count and ratio
Medicare pricing data for 190 providers across 31 states
This procedure has a 6.4x markup — hospitals charge $166.78 but Medicare allows only $26.21. Uninsured patients may face bills 6.4 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 (HCPCS code 86361) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $26.21, but hospitals typically charge $166.78 — a 6.4x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $26.21, 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.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.4x more than what Medicare allows for this procedure. Medicare actually pays $26.21 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $26 | $117 | 4 | 62 | +0.1% |
| Illinois | $26 | $230 | 10 | 872 | +0.1% |
| Kansas | $26 | $195 | 3 | 1,668 | +0.1% |
| Louisiana | $26 | $172 | 2 | 54 | +0.1% |
| Massachusetts | $26 | $185 | 6 | 1,157 | +0.1% |
| Michigan | $26 | $51 | 4 | 158 | +0.1% |
| New Mexico | $26 | $185 | 1 | 48 | +0.1% |
| Pennsylvania | $26 | $176 | 3 | 304 | +0.1% |
| South Dakota | $26 | $192 | 4 | 45 | +0.1% |
| Tennessee | $26 | $113 | 2 | 254 | +0.1% |
| Utah | $26 | $90 | 4 | 102 | +0.1% |
| Washington | $26 | $123 | 6 | 587 | +0.1% |
| Colorado | $26 | $241 | 3 | 486 | +0.1% |
| New Jersey | $26 | $149 | 4 | 3,784 | +0.1% |
| Ohio | $26 | $131 | 7 | 1,166 | +0.1% |
| Texas | $26 | $171 | 14 | 3,550 | +0.1% |
| California | $26 | $180 | 12 | 6,581 | +0.1% |
| Florida | $26 | $195 | 13 | 5,129 | +0.0% |
| North Carolina | $26 | $153 | 9 | 5,944 | +0.0% |
| Oregon | $26 | $67 | 6 | 109 | 0.0% |
| Alabama | $26 | $135 | 3 | 1,890 | 0.0% |
| Puerto Rico | $26 | $35 | 18 | 80 | -0.1% |
| Wisconsin | $26 | $228 | 5 | 245 | -0.2% |
| Maryland | $26 | $147 | 3 | 1,573 | -0.2% |
| Hawaii | $26 | $50 | 2 | 117 | -0.3% |
| Nevada | $26 | $160 | 2 | 137 | -0.5% |
| Arizona | $26 | $159 | 4 | 1,107 | -0.5% |
| Virginia | $26 | $103 | 4 | 551 | -0.6% |
| Indiana | $26 | $199 | 2 | 46 | -1.3% |
| Oklahoma | $26 | $177 | 5 | 425 | -1.3% |
| North Dakota | $26 | $117 | 3 | 23 | -2.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber