86705

Hepatitis b core antibody (igm) measurement

Medicare pricing data for 1,001 providers across 45 states

🤖AI Overview

This procedure has a 7.5x markup — hospitals charge $86.46 but Medicare allows only $11.51. Uninsured patients may face bills 7.5 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

Hepatitis b core antibody (igm) measurement (HCPCS code 86705) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.51, but hospitals typically charge $86.46 — a 7.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.30

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.51, your out-of-pocket cost would be approximately $2.30. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.51
Average Hospital Charge
$86.46
Markup Ratio
7.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$86.46
Medicare Allowed$11.51
Medicare Payment$11.51

Hospitals charge 7.5x more than what Medicare allows for this procedure. Medicare actually pays $11.51 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$12$17126+0.2%
Georgia$12$1436729+0.2%
Idaho$12$59614+0.2%
Illinois$12$104451,133+0.2%
Kansas$12$12510671+0.2%
Maine$12$40316+0.2%
Minnesota$12$15220149+0.2%
Missouri$12$402437+0.2%
Nevada$12$1276127+0.2%
New Mexico$12$51239+0.2%
North Dakota$12$40432+0.2%
Oklahoma$12$828234+0.2%
Utah$12$251021+0.2%
Puerto Rico$12$131533+0.2%
Arkansas$12$271760+0.2%
California$12$67818,026+0.2%
Colorado$12$1018300+0.2%
Florida$12$102424,200+0.1%
New Jersey$12$108526,194+0.1%
Alabama$12$869610+0.1%
Massachusetts$12$1051148630.0%
Michigan$12$37133300.0%
New York$12$871011,8410.0%
North Carolina$12$92524,6130.0%
Pennsylvania$12$52161,4500.0%
Texas$12$105583,9530.0%
Virginia$12$50164960.0%
Hawaii$11$352126-0.2%
Maryland$11$8123608-0.2%
Ohio$11$72301,548-0.2%
Arizona$11$56483,744-0.3%
Louisiana$11$5225160-0.4%
Kentucky$11$306124-0.5%
Tennessee$11$8528491-0.5%
Washington$11$10322726-0.6%
South Carolina$11$5616167-0.9%
Iowa$11$791080-1.0%
Indiana$11$78754-1.1%
Wisconsin$11$888272-1.1%
Oregon$11$368113-1.3%
Rhode Island$11$43343-1.4%
South Dakota$11$70360-1.5%
Nebraska$11$25253-1.7%
Mississippi$11$82479-2.1%
Connecticut$11$65412-4.3%

⚠️ 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