Measurement of tissue transglutaminase
Medicare pricing data for 1,332 providers across 42 states
This procedure has a 11.5x markup — hospitals charge $129.91 but Medicare allows only $11.28. Uninsured patients may face bills 11.5 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
Measurement of tissue transglutaminase (HCPCS code 86364) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.28, but hospitals typically charge $129.91 — a 11.5x 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 $11.28, your out-of-pocket cost would be approximately $2.26. 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 11.5x more than what Medicare allows for this procedure. Medicare actually pays $11.28 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Mississippi | $11 | $49 | 4 | 81 | +1.0% |
| Georgia | $11 | $175 | 2 | 4,391 | +0.2% |
| Idaho | $11 | $30 | 2 | 35 | +0.2% |
| Indiana | $11 | $78 | 2 | 283 | +0.2% |
| Kansas | $11 | $158 | 10 | 3,534 | +0.2% |
| Louisiana | $11 | $86 | 3 | 25 | +0.2% |
| Massachusetts | $11 | $153 | 251 | 6,808 | +0.2% |
| Missouri | $11 | $35 | 13 | 28 | +0.2% |
| Nebraska | $11 | $32 | 5 | 226 | +0.2% |
| New Hampshire | $11 | $35 | 28 | 116 | +0.2% |
| New Mexico | $11 | $37 | 1 | 690 | +0.2% |
| New York | $11 | $225 | 45 | 3,145 | +0.2% |
| South Carolina | $11 | $30 | 3 | 82 | +0.2% |
| Puerto Rico | $11 | $12 | 4 | 53 | +0.2% |
| Colorado | $11 | $134 | 9 | 2,588 | +0.2% |
| Connecticut | $11 | $58 | 3 | 54 | +0.2% |
| Florida | $11 | $161 | 14 | 11,956 | +0.1% |
| New Jersey | $11 | $140 | 132 | 33,356 | +0.1% |
| North Carolina | $11 | $113 | 16 | 33,809 | +0.1% |
| Pennsylvania | $11 | $159 | 9 | 2,731 | +0.1% |
| South Dakota | $11 | $51 | 5 | 603 | +0.1% |
| Texas | $11 | $151 | 81 | 14,356 | +0.1% |
| Washington | $11 | $103 | 48 | 5,760 | +0.1% |
| Nevada | $11 | $175 | 1 | 687 | 0.0% |
| Oregon | $11 | $50 | 6 | 486 | 0.0% |
| California | $11 | $131 | 29 | 14,138 | 0.0% |
| Hawaii | $11 | $100 | 2 | 280 | -0.1% |
| Maryland | $11 | $134 | 8 | 2,309 | -0.1% |
| Michigan | $11 | $85 | 10 | 376 | -0.1% |
| Ohio | $11 | $93 | 12 | 5,979 | -0.1% |
| Oklahoma | $11 | $123 | 5 | 1,007 | -0.1% |
| Tennessee | $11 | $89 | 8 | 355 | -0.1% |
| Arizona | $11 | $103 | 4 | 6,773 | -0.1% |
| Illinois | $11 | $137 | 138 | 3,676 | -0.2% |
| Minnesota | $11 | $135 | 317 | 3,782 | -0.2% |
| Iowa | $11 | $58 | 7 | 842 | -0.3% |
| Utah | $11 | $30 | 42 | 1,239 | -0.3% |
| Alabama | $11 | $107 | 4 | 6,664 | -0.3% |
| Maine | $11 | $45 | 3 | 159 | -0.4% |
| North Dakota | $11 | $51 | 6 | 135 | -0.4% |
| Virginia | $11 | $40 | 11 | 1,645 | -0.5% |
| Wisconsin | $11 | $88 | 16 | 1,585 | -0.8% |
⚠️ 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