Rheumatoid factor level
Medicare pricing data for 7,677 providers across 51 states
This procedure has a 7.6x markup — hospitals charge $42.13 but Medicare allows only $5.55. Uninsured patients may face bills 7.6 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
Rheumatoid factor level (HCPCS code 86431) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.55, but hospitals typically charge $42.13 — a 7.6x 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 $5.55, your out-of-pocket cost would be approximately $1.11. 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 7.6x more than what Medicare allows for this procedure. Medicare actually pays $5.55 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Delaware | $6 | $11 | 3 | 33 | +0.2% |
| Kansas | $6 | $55 | 74 | 11,498 | +0.2% |
| Nevada | $6 | $59 | 8 | 3,317 | +0.2% |
| New Mexico | $6 | $25 | 19 | 1,660 | +0.2% |
| North Dakota | $6 | $17 | 14 | 4,192 | +0.2% |
| West Virginia | $6 | $58 | 10 | 41 | +0.2% |
| Wyoming | $6 | $40 | 9 | 86 | +0.2% |
| Puerto Rico | $6 | $6 | 142 | 554 | +0.2% |
| Alaska | $6 | $58 | 31 | 63 | +0.2% |
| California | $6 | $37 | 146 | 111,221 | +0.2% |
| Florida | $6 | $51 | 515 | 44,653 | 0.0% |
| Georgia | $6 | $56 | 195 | 13,067 | 0.0% |
| Illinois | $6 | $49 | 373 | 12,778 | 0.0% |
| Maine | $6 | $20 | 23 | 596 | 0.0% |
| Massachusetts | $6 | $53 | 411 | 9,177 | 0.0% |
| New Jersey | $6 | $45 | 208 | 72,488 | 0.0% |
| New York | $6 | $45 | 843 | 22,174 | 0.0% |
| North Carolina | $6 | $44 | 370 | 45,959 | 0.0% |
| South Dakota | $6 | $33 | 34 | 421 | 0.0% |
| Texas | $6 | $46 | 478 | 54,971 | 0.0% |
| Utah | $6 | $19 | 183 | 1,136 | 0.0% |
| Arizona | $6 | $44 | 139 | 17,177 | 0.0% |
| Colorado | $6 | $48 | 35 | 2,903 | 0.0% |
| Hawaii | $6 | $22 | 2 | 3,051 | -0.2% |
| Maryland | $6 | $40 | 154 | 6,990 | -0.2% |
| Minnesota | $6 | $41 | 550 | 3,703 | -0.2% |
| Missouri | $6 | $41 | 228 | 2,027 | -0.2% |
| New Hampshire | $6 | $21 | 55 | 241 | -0.2% |
| Ohio | $6 | $37 | 186 | 16,830 | -0.2% |
| Pennsylvania | $6 | $42 | 66 | 7,521 | -0.2% |
| Washington | $6 | $40 | 169 | 8,136 | -0.2% |
| Alabama | $6 | $39 | 152 | 15,032 | -0.2% |
| Connecticut | $6 | $31 | 100 | 535 | -0.2% |
| Idaho | $6 | $24 | 23 | 688 | -0.4% |
| Indiana | $6 | $27 | 43 | 1,864 | -0.4% |
| Louisiana | $6 | $26 | 86 | 1,879 | -0.4% |
| Montana | $6 | $15 | 2 | 147 | -0.4% |
| Nebraska | $6 | $24 | 36 | 814 | -0.4% |
| Oklahoma | $6 | $30 | 74 | 6,047 | -0.4% |
| Oregon | $6 | $23 | 56 | 2,186 | -0.4% |
| Rhode Island | $6 | $22 | 10 | 461 | -0.4% |
| South Carolina | $6 | $32 | 125 | 3,036 | -0.4% |
| Virginia | $6 | $19 | 126 | 3,852 | -0.4% |
| District of Columbia | $6 | $19 | 7 | 107 | -0.5% |
| Iowa | $6 | $26 | 146 | 1,641 | -0.5% |
| Michigan | $6 | $16 | 33 | 2,147 | -0.5% |
| Kentucky | $6 | $33 | 80 | 2,815 | -0.7% |
| Mississippi | $6 | $30 | 59 | 1,235 | -0.7% |
| Tennessee | $6 | $31 | 598 | 10,656 | -0.7% |
| Wisconsin | $5 | $54 | 60 | 3,458 | -1.1% |
| Arkansas | $5 | $24 | 174 | 1,967 | -1.1% |
⚠️ 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