86664

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

Medicare pricing data for 437 providers across 39 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $91.84 but Medicare allows only $14.94. Uninsured patients may face bills 6.1 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), nuclear antigen (HCPCS code 86664) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.94, but hospitals typically charge $91.84 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.94, your out-of-pocket cost would be approximately $2.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.94
Average Hospital Charge
$91.84
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$91.84
Medicare Allowed$14.94
Medicare Payment$14.94

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $14.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$15$1132633+0.3%
Illinois$15$1113576+0.3%
Kansas$15$1075623+0.3%
Louisiana$15$481777+0.3%
Maryland$15$1145256+0.3%
Massachusetts$15$10937658+0.3%
Michigan$15$43840+0.3%
Nebraska$15$25125+0.3%
New Mexico$15$145145+0.3%
North Dakota$15$42217+0.3%
Pennsylvania$15$1086385+0.3%
Rhode Island$15$40146+0.3%
South Carolina$15$45222+0.3%
Tennessee$15$914173+0.3%
Colorado$15$946156+0.3%
Connecticut$15$54923+0.3%
New York$15$76393,050+0.2%
New Jersey$15$85417,603+0.1%
Texas$15$88502,451+0.1%
Washington$15$1106415+0.1%
California$15$102252,8390.0%
North Carolina$15$91123,025-0.1%
Ohio$15$83211,091-0.1%
Florida$15$118172,633-0.1%
Nevada$15$1122148-0.2%
Oklahoma$15$935193-0.2%
Arizona$15$7951,350-0.3%
Oregon$15$64391-0.6%
Alabama$15$957636-0.7%
Hawaii$15$602120-0.7%
Minnesota$15$12922186-0.7%
Wisconsin$15$98638-1.2%
Kentucky$15$622143-1.4%
Utah$15$231797-2.4%
South Dakota$14$90229-3.2%
Virginia$14$465128-3.3%
Maine$14$66429-5.4%
Indiana$14$71427-5.9%
Iowa$14$52630-7.8%

⚠️ 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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