86611

Analysis for antibody to bartonella (bacteria)

Medicare pricing data for 118 providers across 24 states

🤖AI Overview

This procedure has a 6.4x markup — hospitals charge $63.30 but Medicare allows only $9.93. Uninsured patients may face bills 6.4 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

Analysis for antibody to bartonella (bacteria) (HCPCS code 86611) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.93, but hospitals typically charge $63.30 — a 6.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.93, your out-of-pocket cost would be approximately $1.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$9.93
Average Hospital Charge
$63.30
Markup Ratio
6.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$63.30
Medicare Allowed$9.93
Medicare Payment$9.93

Hospitals charge 6.4x more than what Medicare allows for this procedure. Medicare actually pays $9.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$10$884410+0.5%
Georgia$10$861169+0.5%
Hawaii$10$45239+0.5%
Illinois$10$961161+0.5%
Kansas$10$733169+0.5%
Maryland$10$924167+0.5%
Massachusetts$10$1073395+0.5%
Minnesota$10$874304+0.5%
Nevada$10$66153+0.5%
New York$10$486712+0.5%
Ohio$10$68542+0.5%
Oklahoma$10$59394+0.5%
Pennsylvania$10$776231+0.5%
Rhode Island$10$30172+0.5%
Texas$10$769309+0.5%
Utah$10$26341+0.5%
Washington$10$103111+0.5%
Arizona$10$1023105+0.5%
California$10$39139,401+0.2%
Tennessee$10$642103-0.5%
New Jersey$10$115103,763-0.6%
Virginia$10$17479-0.8%
North Carolina$10$443196-3.5%
Wisconsin$9$72436-7.4%

⚠️ 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