86644

Analysis for antibody to cytomegalovirus (cmv)

Medicare pricing data for 315 providers across 36 states

🤖AI Overview

This procedure has a 7.6x markup — hospitals charge $106.04 but Medicare allows only $14.02. 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

Analysis for antibody to cytomegalovirus (cmv) (HCPCS code 86644) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.02, but hospitals typically charge $106.04 — a 7.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.02, your out-of-pocket cost would be approximately $2.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.02
Average Hospital Charge
$106.04
Markup Ratio
7.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$106.04
Medicare Allowed$14.02
Medicare Payment$14.02

Hospitals charge 7.6x more than what Medicare allows for this procedure. Medicare actually pays $14.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$14$1492258+0.6%
Hawaii$14$48252+0.6%
Indiana$14$68923+0.6%
Maryland$14$1284137+0.6%
Massachusetts$14$12523344+0.6%
Nebraska$14$40113+0.6%
Nevada$14$130262+0.6%
New Mexico$14$44125+0.6%
Oklahoma$14$91486+0.6%
Oregon$14$44362+0.6%
South Dakota$14$83234+0.6%
Tennessee$14$109296+0.6%
Utah$14$30315+0.6%
Virginia$14$496113+0.6%
Washington$14$1007189+0.6%
Puerto Rico$14$161428+0.6%
Colorado$14$116572+0.6%
New Jersey$14$93124,357+0.4%
North Carolina$14$99111,632+0.4%
Kansas$14$1234269+0.4%
Texas$14$105121,159+0.4%
California$14$105291,763+0.4%
Florida$14$155121,567+0.3%
Illinois$14$10025362+0.3%
New York$14$1049708+0.3%
Ohio$14$919601+0.3%
Alabama$14$1086307-0.6%
Michigan$14$54758-0.6%
Arizona$14$1105926-0.6%
Pennsylvania$14$1038208-1.1%
Louisiana$14$481733-1.1%
Wisconsin$14$1076186-2.1%
Iowa$14$64228-2.3%
Kentucky$13$42617-5.3%
Minnesota$13$11926540-6.8%
Maine$11$81113-18.6%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber