86376

Microsomal antibodies (autoantibody) measurement

Medicare pricing data for 3,285 providers across 46 states

🤖AI Overview

This procedure has a 6.5x markup — hospitals charge $92.79 but Medicare allows only $14.24. Uninsured patients may face bills 6.5 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

Microsomal antibodies (autoantibody) measurement (HCPCS code 86376) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.24, but hospitals typically charge $92.79 — a 6.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.24, your out-of-pocket cost would be approximately $2.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.24
Average Hospital Charge
$92.79
Markup Ratio
6.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$92.79
Medicare Allowed$14.24
Medicare Payment$14.24

Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $14.24 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Idaho$14$6618227+0.1%
Illinois$14$118466,885+0.1%
Maine$14$48296+0.1%
New Hampshire$14$591855+0.1%
North Dakota$14$38131,502+0.1%
Wyoming$14$109250+0.1%
Connecticut$14$117977+0.1%
Florida$14$10516054,672+0.1%
Georgia$14$122489,143+0.1%
Kansas$14$120126,460+0.1%
Massachusetts$14$861338,376+0.1%
Missouri$14$154461,197+0.1%
New Jersey$14$10416463,297+0.1%
Pennsylvania$14$73355,174+0.1%
Puerto Rico$14$16217895+0.1%
Colorado$14$99252,942+0.1%
Nevada$14$12384,0500.0%
New York$14$9931835,5790.0%
Ohio$14$8810013,4910.0%
Texas$14$8920053,2950.0%
California$14$8113474,0310.0%
Maryland$14$96855,369-0.1%
Michigan$14$30222,674-0.1%
New Mexico$14$7231,088-0.1%
Arizona$14$999019,700-0.1%
Nebraska$14$452308-0.1%
North Carolina$14$8713137,481-0.1%
Oklahoma$14$96395,098-0.1%
Alabama$14$83289,702-0.1%
Minnesota$14$1132454,418-0.2%
Indiana$14$48271,079-0.3%
Rhode Island$14$405209-0.3%
South Carolina$14$40201,964-0.3%
Washington$14$861673,566-0.3%
Kentucky$14$51361,138-0.4%
Louisiana$14$51481,264-0.4%
Hawaii$14$572713-0.5%
Utah$14$44104644-0.5%
Oregon$14$42581,277-0.6%
Arkansas$14$5254383-0.7%
Tennessee$14$732816,372-0.8%
Iowa$14$618314-0.9%
Wisconsin$14$92191,505-0.9%
South Dakota$14$759288-1.0%
Mississippi$14$6821862-1.4%
Virginia$14$36551,821-2.0%

⚠️ 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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