86481

Tuberculosis test, enumeration of t-cells

Medicare pricing data for 446 providers across 40 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

Tuberculosis test, enumeration of t-cells (HCPCS code 86481) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $96.94, but hospitals typically charge $268.85 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$19.39

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $96.94, your out-of-pocket cost would be approximately $19.39. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$96.94
Average Hospital Charge
$268.85
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$268.85
Medicare Allowed$96.94
Medicare Payment$96.94

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $96.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$98$2896414+1.1%
Indiana$98$2322122+1.1%
Maine$98$145220+1.1%
Maryland$98$3041502+1.1%
Nevada$98$198231+1.1%
New York$98$41851,471+1.1%
Rhode Island$98$279220+1.1%
South Carolina$98$1407111+1.1%
South Dakota$98$217134+1.1%
Utah$98$249212+1.1%
Virginia$98$209239+1.1%
Puerto Rico$98$100356+1.1%
Connecticut$98$127112+1.1%
New Jersey$98$16691,199+1.0%
Texas$98$30392,676+1.0%
Massachusetts$98$25610511+0.9%
California$98$2943910,779+0.9%
Oregon$98$1472529+0.8%
Florida$98$310151,273+0.8%
Michigan$98$1952243+0.7%
Georgia$98$74311417+0.6%
Pennsylvania$98$2308332+0.6%
Wisconsin$98$38121386+0.6%
Tennessee$97$29751,368+0.5%
Idaho$97$3005254+0.4%
North Carolina$97$200352,192+0.4%
Iowa$97$1712276+0.4%
Kansas$97$249111,276+0.3%
Arizona$97$21522,779+0.3%
Kentucky$97$1818628+0.2%
Oklahoma$97$1895974-0.1%
New Mexico$97$2002260-0.2%
Nebraska$96$1957233-0.6%
Minnesota$96$323106581-0.7%
Alabama$96$12712455-1.1%
Mississippi$96$2582467-1.2%
Washington$96$22763171-1.3%
Missouri$96$206227-1.4%
Arkansas$96$1756411-1.4%
Ohio$81$20131,149-16.6%

⚠️ 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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