86762

Analysis for antibody to rubella (german measles virus)

Medicare pricing data for 642 providers across 37 states

🤖AI Overview

This procedure has a 5.8x markup — hospitals charge $81.14 but Medicare allows only $14.06. Uninsured patients may face bills 5.8 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 rubella (german measles virus) (HCPCS code 86762) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.06, but hospitals typically charge $81.14 — a 5.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.81

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.06, your out-of-pocket cost would be approximately $2.81. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.06
Average Hospital Charge
$81.14
Markup Ratio
5.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$81.14
Medicare Allowed$14.06
Medicare Payment$14.06

Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $14.06 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$14$842136+0.3%
Iowa$14$41818+0.3%
Kansas$14$825324+0.3%
Louisiana$14$45411+0.3%
Maryland$14$7314261+0.3%
Massachusetts$14$7668555+0.3%
Nevada$14$73672+0.3%
New Mexico$14$47221+0.3%
Oklahoma$14$60582+0.3%
Pennsylvania$14$6414274+0.3%
Rhode Island$14$31213+0.3%
South Dakota$14$89223+0.3%
Tennessee$14$67659+0.3%
Texas$14$8332607+0.3%
Utah$14$28416+0.3%
Puerto Rico$14$18814+0.3%
Arizona$14$936243+0.3%
Colorado$14$955105+0.3%
Connecticut$14$491542+0.3%
New York$14$881022,213+0.2%
New Jersey$14$81525,568+0.1%
California$14$84494,4130.0%
North Carolina$14$87161,259-0.1%
Minnesota$14$8447184-0.2%
Florida$14$8813598-0.3%
Ohio$14$7717345-0.3%
Alabama$14$856225-0.3%
Illinois$14$7033275-0.4%
Michigan$14$37744-1.0%
Hawaii$14$37240-1.3%
Wisconsin$14$6210121-1.3%
Oregon$14$381645-1.9%
Virginia$14$459112-2.1%
Maine$14$341032-2.2%
Washington$14$6113241-2.2%
Kentucky$13$47422-4.3%
Indiana$13$44626-7.0%

⚠️ 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