86709

Measurement of hepatitis a antibody (igm)

Medicare pricing data for 819 providers across 41 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $79.51 but Medicare allows only $11.01. Uninsured patients may face bills 7.2 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

Measurement of hepatitis a antibody (igm) (HCPCS code 86709) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.01, but hospitals typically charge $79.51 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.20

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.01, your out-of-pocket cost would be approximately $2.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.01
Average Hospital Charge
$79.51
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$79.51
Medicare Allowed$11.01
Medicare Payment$11.01

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $11.01 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Missouri$11$372655+0.3%
Georgia$11$1293343+0.2%
Hawaii$11$442157+0.2%
Illinois$11$7928635+0.2%
Indiana$11$104537+0.2%
Kansas$11$1238315+0.2%
Louisiana$11$521260+0.2%
Maine$11$55211+0.2%
Michigan$11$3113207+0.2%
Nebraska$11$35146+0.2%
Nevada$11$1224157+0.2%
New Mexico$11$45222+0.2%
Rhode Island$11$79377+0.2%
South Carolina$11$331077+0.2%
Utah$11$27713+0.2%
Washington$11$9291,006+0.2%
Puerto Rico$11$132145+0.2%
Arkansas$11$261655+0.2%
Colorado$11$994266+0.2%
Massachusetts$11$10363643+0.1%
New Jersey$11$83358,230+0.1%
New York$11$781422,743+0.1%
North Carolina$11$95132,355+0.1%
Pennsylvania$11$39141,077+0.1%
California$11$60668,560+0.1%
Florida$11$107332,0530.0%
Maryland$11$82344290.0%
Ohio$11$8730967-0.1%
Texas$11$95391,748-0.1%
Alabama$11$947860-0.1%
Tennessee$11$7240172-0.3%
Virginia$11$4312172-0.3%
Arizona$11$93191,790-0.3%
Mississippi$11$805303-0.4%
Oregon$11$417448-0.5%
Oklahoma$11$899361-0.8%
South Dakota$11$66562-1.2%
Wisconsin$11$1067144-1.2%
Minnesota$11$11620175-1.5%
North Dakota$11$44432-2.3%
Iowa$11$63630-2.5%

⚠️ 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