86671

Analysis for antibody to fungus

Medicare pricing data for 138 providers across 27 states

🤖AI Overview

This procedure has a 9.8x markup — hospitals charge $117.47 but Medicare allows only $11.96. Uninsured patients may face bills 9.8 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 fungus (HCPCS code 86671) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.96, but hospitals typically charge $117.47 — a 9.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.39

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.96, your out-of-pocket cost would be approximately $2.39. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.96
Average Hospital Charge
$117.47
Markup Ratio
9.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$117.47
Medicare Allowed$11.96
Medicare Payment$11.96

Hospitals charge 9.8x more than what Medicare allows for this procedure. Medicare actually pays $11.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$12$125250+0.4%
New Mexico$12$38130+0.4%
Florida$12$14161,441+0.3%
Georgia$12$1431496+0.3%
Illinois$12$1462165+0.3%
Indiana$12$96224+0.3%
Kansas$12$1354308+0.3%
Maryland$12$1424238+0.3%
Massachusetts$12$1482146+0.3%
Minnesota$12$172236+0.3%
New York$12$947710+0.3%
Ohio$12$989501+0.3%
Oklahoma$12$1384400+0.3%
Pennsylvania$12$1455605+0.3%
Tennessee$12$582316+0.3%
Texas$12$126101,478+0.3%
Utah$12$41451+0.3%
Wisconsin$12$106324+0.3%
Alabama$12$893442+0.3%
Arizona$12$1524708+0.3%
Colorado$12$1043110+0.3%
California$12$130131,708+0.3%
North Carolina$12$10075,436+0.2%
Washington$12$1043327+0.1%
Nevada$12$1491166-0.3%
New Jersey$12$123104,966-0.4%
Virginia$11$404142-12.0%

⚠️ 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