Screening test for presence of antibody
Medicare pricing data for 170 providers across 25 states
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
Screening test for presence of antibody (HCPCS code 86403) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.29, but hospitals typically charge $49.14 — a 4.4x 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 $11.29, 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 4.4x more than what Medicare allows for this procedure. Medicare actually pays $11.29 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $11 | $51 | 13 | 1,620 | +0.2% |
| Georgia | $11 | $119 | 5 | 98 | +0.2% |
| Hawaii | $11 | $53 | 2 | 31 | +0.2% |
| Iowa | $11 | $34 | 3 | 81 | +0.2% |
| Kansas | $11 | $129 | 3 | 115 | +0.2% |
| Maine | $11 | $37 | 10 | 11 | +0.2% |
| Maryland | $11 | $101 | 5 | 19 | +0.2% |
| Massachusetts | $11 | $135 | 2 | 25 | +0.2% |
| Nebraska | $11 | $26 | 3 | 11 | +0.2% |
| Nevada | $11 | $120 | 2 | 65 | +0.2% |
| North Carolina | $11 | $39 | 4 | 39 | +0.2% |
| Ohio | $11 | $68 | 4 | 162 | +0.2% |
| Pennsylvania | $11 | $96 | 11 | 25 | +0.2% |
| South Carolina | $11 | $35 | 1 | 31 | +0.2% |
| Tennessee | $11 | $39 | 5 | 21 | +0.2% |
| Texas | $11 | $117 | 10 | 226 | +0.2% |
| Wisconsin | $11 | $46 | 2 | 20 | +0.2% |
| Arizona | $11 | $95 | 1 | 45 | +0.2% |
| Illinois | $11 | $47 | 2 | 183 | 0.0% |
| California | $11 | $38 | 26 | 6,622 | 0.0% |
| Oklahoma | $11 | $45 | 5 | 143 | -0.4% |
| New Jersey | $11 | $157 | 3 | 268 | -0.9% |
| Virginia | $11 | $35 | 4 | 23 | -0.9% |
| Mississippi | $11 | $31 | 14 | 113 | -1.1% |
| Indiana | $11 | $55 | 6 | 19 | -5.1% |
⚠️ 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