86663

Analysis for antibody to epstein-barr virus (mononucleosis virus), early antigen

Medicare pricing data for 348 providers across 37 states

🤖AI Overview

This procedure has a 7.0x markup — hospitals charge $89.53 but Medicare allows only $12.83. Uninsured patients may face bills 7.0 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 epstein-barr virus (mononucleosis virus), early antigen (HCPCS code 86663) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.83, but hospitals typically charge $89.53 — a 7.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.83, your out-of-pocket cost would be approximately $2.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.83
Average Hospital Charge
$89.53
Markup Ratio
7.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$89.53
Medicare Allowed$12.83
Medicare Payment$12.83

Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $12.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$13$1401135+0.2%
Illinois$13$13216150+0.2%
Kansas$13$1235146+0.2%
Louisiana$13$76365+0.2%
Maryland$13$1244145+0.2%
Massachusetts$13$12437400+0.2%
Michigan$13$38727+0.2%
Minnesota$13$83420+0.2%
Nebraska$13$20125+0.2%
Nevada$13$135260+0.2%
New Mexico$13$124246+0.2%
North Dakota$13$37216+0.2%
Pennsylvania$13$1096214+0.2%
Rhode Island$13$34141+0.2%
South Carolina$13$30225+0.2%
Tennessee$13$572153+0.2%
Virginia$13$41436+0.2%
Wisconsin$13$97638+0.2%
Puerto Rico$13$151221+0.2%
Colorado$13$101391+0.2%
New Jersey$13$87154,634+0.2%
New York$13$71383,036+0.2%
Texas$13$103521,596+0.2%
Florida$13$125141,091+0.1%
California$13$102201,247+0.1%
Ohio$13$738616-0.1%
North Carolina$13$84111,978-0.2%
Washington$13$1284188-0.2%
Arizona$13$925548-0.2%
Oklahoma$13$884112-0.5%
Oregon$13$39494-0.6%
Hawaii$13$512121-0.8%
Alabama$13$916223-1.1%
Kentucky$13$46164-1.2%
Utah$12$2218125-3.3%
Maine$12$58227-5.8%
South Dakota$12$71214-6.9%

⚠️ 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