Analysis for antibody, treponema pallidum
Medicare pricing data for 1,738 providers across 49 states
This procedure has a 5.8x markup — hospitals charge $74.92 but Medicare allows only $12.95. 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, treponema pallidum (HCPCS code 86780) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.95, but hospitals typically charge $74.92 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.95, your out-of-pocket cost would be approximately $2.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $12.95 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Georgia | $13 | $103 | 9 | 740 | +0.2% |
| Idaho | $13 | $34 | 10 | 68 | +0.2% |
| Kansas | $13 | $87 | 20 | 581 | +0.2% |
| Louisiana | $13 | $47 | 47 | 229 | +0.2% |
| Michigan | $13 | $44 | 14 | 616 | +0.2% |
| Mississippi | $13 | $61 | 5 | 109 | +0.2% |
| Missouri | $13 | $47 | 12 | 34 | +0.2% |
| Montana | $13 | $41 | 15 | 30 | +0.2% |
| Nebraska | $13 | $27 | 5 | 52 | +0.2% |
| New Hampshire | $13 | $55 | 10 | 31 | +0.2% |
| New Mexico | $13 | $44 | 5 | 392 | +0.2% |
| North Dakota | $13 | $57 | 17 | 61 | +0.2% |
| Rhode Island | $13 | $25 | 4 | 242 | +0.2% |
| South Dakota | $13 | $77 | 4 | 40 | +0.2% |
| Tennessee | $13 | $106 | 6 | 92 | +0.2% |
| Vermont | $13 | $30 | 13 | 27 | +0.2% |
| Arkansas | $13 | $34 | 26 | 83 | +0.2% |
| Colorado | $13 | $95 | 12 | 304 | +0.2% |
| Connecticut | $13 | $43 | 9 | 94 | +0.2% |
| Illinois | $13 | $92 | 85 | 1,349 | +0.2% |
| New Jersey | $13 | $93 | 35 | 6,004 | +0.2% |
| New York | $13 | $78 | 167 | 4,756 | +0.2% |
| Pennsylvania | $13 | $46 | 20 | 1,393 | +0.2% |
| Texas | $13 | $48 | 94 | 6,293 | +0.2% |
| Alabama | $13 | $88 | 8 | 1,080 | +0.2% |
| Florida | $13 | $96 | 30 | 3,267 | +0.1% |
| Massachusetts | $13 | $88 | 149 | 2,655 | +0.1% |
| North Carolina | $13 | $92 | 63 | 5,293 | +0.1% |
| California | $13 | $88 | 77 | 3,069 | +0.1% |
| Nevada | $13 | $80 | 11 | 140 | -0.1% |
| Ohio | $13 | $85 | 65 | 1,349 | -0.1% |
| Maryland | $13 | $77 | 38 | 944 | -0.2% |
| Oklahoma | $13 | $63 | 27 | 721 | -0.2% |
| Washington | $13 | $53 | 109 | 965 | -0.2% |
| Kentucky | $13 | $23 | 5 | 400 | -0.2% |
| Oregon | $13 | $32 | 29 | 466 | -0.2% |
| Virginia | $13 | $37 | 19 | 1,760 | -0.3% |
| Wisconsin | $13 | $63 | 17 | 339 | -0.3% |
| Minnesota | $13 | $65 | 302 | 1,331 | -0.5% |
| Utah | $13 | $29 | 8 | 32 | -0.5% |
| Indiana | $13 | $61 | 7 | 221 | -0.5% |
| Arizona | $13 | $96 | 6 | 450 | -0.7% |
| Maine | $13 | $37 | 38 | 230 | -0.9% |
| West Virginia | $13 | $99 | 3 | 64 | -0.9% |
| Iowa | $13 | $60 | 41 | 186 | -1.2% |
| Hawaii | $13 | $65 | 2 | 36 | -2.1% |
| South Carolina | $13 | $40 | 5 | 25 | -3.3% |
| Alaska | $12 | $61 | 13 | 26 | -3.6% |
| Puerto Rico | $12 | $13 | 17 | 51 | -9.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber