Rheumatoid factor analysis
Medicare pricing data for 1,360 providers across 41 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
Rheumatoid factor analysis (HCPCS code 86430) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6.01, but hospitals typically charge $27.13 — a 4.5x 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 $6.01, your out-of-pocket cost would be approximately $1.20. 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 4.5x more than what Medicare allows for this procedure. Medicare actually pays $6.01 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $6 | $12 | 85 | 3,485 | +0.3% |
| Delaware | $6 | $14 | 2 | 14 | +0.2% |
| Idaho | $6 | $30 | 19 | 208 | +0.2% |
| Illinois | $6 | $14 | 18 | 2,163 | +0.2% |
| Iowa | $6 | $29 | 10 | 34 | +0.2% |
| Kentucky | $6 | $34 | 19 | 140 | +0.2% |
| Louisiana | $6 | $28 | 5 | 188 | +0.2% |
| Maryland | $6 | $17 | 3 | 24 | +0.2% |
| Michigan | $6 | $11 | 30 | 2,029 | +0.2% |
| Minnesota | $6 | $31 | 47 | 92 | +0.2% |
| Missouri | $6 | $21 | 8 | 20 | +0.2% |
| Montana | $6 | $18 | 1 | 22 | +0.2% |
| Nebraska | $6 | $18 | 17 | 49 | +0.2% |
| New Jersey | $6 | $72 | 9 | 537 | +0.2% |
| New Mexico | $6 | $25 | 9 | 22 | +0.2% |
| New York | $6 | $56 | 59 | 17,579 | +0.2% |
| Oklahoma | $6 | $34 | 32 | 106 | +0.2% |
| South Carolina | $6 | $6 | 2 | 55 | +0.2% |
| Arkansas | $6 | $21 | 18 | 59 | +0.2% |
| California | $6 | $15 | 98 | 27,924 | +0.2% |
| Colorado | $6 | $20 | 5 | 21 | +0.2% |
| Massachusetts | $6 | $25 | 6 | 383 | 0.0% |
| South Dakota | $6 | $39 | 5 | 118 | 0.0% |
| Puerto Rico | $6 | $7 | 205 | 542 | 0.0% |
| Kansas | $6 | $38 | 41 | 743 | -0.2% |
| North Carolina | $6 | $24 | 68 | 3,623 | -0.2% |
| West Virginia | $6 | $20 | 2 | 282 | -0.2% |
| Tennessee | $6 | $19 | 74 | 188 | -0.3% |
| Texas | $6 | $14 | 96 | 4,209 | -0.3% |
| Wisconsin | $6 | $52 | 64 | 296 | -0.5% |
| Arizona | $6 | $15 | 33 | 499 | -0.5% |
| Indiana | $6 | $30 | 62 | 606 | -0.8% |
| Ohio | $6 | $27 | 17 | 630 | -1.0% |
| Oregon | $6 | $17 | 42 | 344 | -1.0% |
| Alabama | $6 | $22 | 45 | 639 | -1.0% |
| Pennsylvania | $6 | $17 | 6 | 372 | -1.2% |
| Georgia | $6 | $29 | 37 | 118 | -1.5% |
| Mississippi | $6 | $35 | 29 | 511 | -1.8% |
| Washington | $6 | $15 | 13 | 35 | -2.0% |
| Utah | $6 | $18 | 4 | 32 | -2.5% |
| Hawaii | $6 | $69 | 2 | 106 | -5.2% |
⚠️ 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