86800

Thyroglobulin (thyroid protein) antibody measurement

Medicare pricing data for 2,078 providers across 45 states

🤖AI Overview

This procedure has a 6.0x markup — hospitals charge $92.97 but Medicare allows only $15.56. Uninsured patients may face bills 6.0 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

Thyroglobulin (thyroid protein) antibody measurement (HCPCS code 86800) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $15.56, but hospitals typically charge $92.97 — a 6.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $15.56, your out-of-pocket cost would be approximately $3.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$15.56
Average Hospital Charge
$92.97
Markup Ratio
6.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$92.97
Medicare Allowed$15.56
Medicare Payment$15.56

Hospitals charge 6.0x more than what Medicare allows for this procedure. Medicare actually pays $15.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Missouri$16$182221,069+0.3%
Illinois$16$114325,119+0.2%
Louisiana$16$5334303+0.2%
New Hampshire$16$471998+0.2%
Connecticut$16$76860+0.2%
Florida$16$9411539,967+0.1%
Georgia$16$115206,866+0.1%
Kansas$16$110135,343+0.1%
Massachusetts$16$761138,201+0.1%
Nevada$16$11053,198+0.1%
North Dakota$16$4311854+0.1%
Pennsylvania$16$76304,644+0.1%
Puerto Rico$16$18186672+0.1%
Colorado$16$106191,946+0.1%
New Jersey$16$10414450,213+0.1%
California$16$778448,719+0.1%
Maryland$16$94594,7350.0%
Michigan$16$36222,8780.0%
Minnesota$16$139421,4410.0%
New York$16$10025331,8870.0%
North Carolina$16$1015923,4560.0%
Ohio$16$978610,7730.0%
Texas$16$9111028,7200.0%
Arizona$16$985714,4080.0%
Indiana$16$5717573-0.1%
Utah$16$3788952-0.1%
Kentucky$16$5929942-0.1%
Maine$16$522186-0.1%
New Mexico$16$542480-0.1%
Oklahoma$16$89152,483-0.2%
Washington$16$911022,500-0.2%
Alabama$16$99195,602-0.2%
Iowa$16$578292-0.4%
Rhode Island$15$565299-0.4%
Idaho$15$7518227-0.5%
South Carolina$15$4217660-0.5%
Tennessee$15$90513,231-0.6%
Wisconsin$15$91151,259-0.8%
Oregon$15$6640968-0.9%
Hawaii$15$572992-1.2%
Mississippi$15$6220780-1.3%
Virginia$15$43481,787-1.9%
South Dakota$15$625206-2.0%
Nebraska$15$272224-4.0%
Arkansas$14$481849-6.9%

⚠️ 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