86413

Quantitative measurement of severe acute respiratory syndrome coronavirus 2 (covid-19] antibody

Medicare pricing data for 34 providers across 10 states

🤖AI Overview

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

Quantitative measurement of severe acute respiratory syndrome coronavirus 2 (covid-19] antibody (HCPCS code 86413) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $43.02, but hospitals typically charge $66.54 — a 1.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $43.02, your out-of-pocket cost would be approximately $8.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$43.02
Average Hospital Charge
$66.54
Markup Ratio
1.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$66.54
Medicare Allowed$43.02
Medicare Payment$43.02

Hospitals charge 1.5x more than what Medicare allows for this procedure. Medicare actually pays $43.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$50$5511,837+17.2%
Kentucky$50$72750+15.2%
Arizona$49$1502768+14.8%
Alabama$49$1481468+14.1%
Virginia$42$10351,295-3.3%
Florida$41$552875-4.0%
Pennsylvania$41$421905-4.0%
Arkansas$41$84190-4.0%
Texas$41$55119,230-4.0%
South Carolina$41$1031234-4.9%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber