86880

Red blood cell antibody detection test, direct

Medicare pricing data for 314 providers across 39 states

🤖AI Overview

This procedure has a 8.5x markup — hospitals charge $44.55 but Medicare allows only $5.27. Uninsured patients may face bills 8.5 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

Red blood cell antibody detection test, direct (HCPCS code 86880) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.27, but hospitals typically charge $44.55 — a 8.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.05

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.27, your out-of-pocket cost would be approximately $1.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.27
Average Hospital Charge
$44.55
Markup Ratio
8.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$44.55
Medicare Allowed$5.27
Medicare Payment$5.27

Hospitals charge 8.5x more than what Medicare allows for this procedure. Medicare actually pays $5.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$5$50115,017+0.2%
Georgia$5$44423+0.2%
Hawaii$5$212179+0.2%
Indiana$5$51583+0.2%
Kansas$5$466854+0.2%
Kentucky$5$37216+0.2%
Louisiana$5$28415+0.2%
Maine$5$112115+0.2%
Massachusetts$5$345450+0.2%
Minnesota$5$4846498+0.2%
Nevada$5$413279+0.2%
New Jersey$5$40139,002+0.2%
New Mexico$5$138171+0.2%
New York$5$12581,205+0.2%
North Dakota$5$63279+0.2%
Ohio$5$4291,034+0.2%
Oklahoma$5$453398+0.2%
Oregon$5$272113+0.2%
Rhode Island$5$22213+0.2%
South Carolina$5$47612+0.2%
Utah$5$17122+0.2%
Virginia$5$545190+0.2%
Washington$5$497392+0.2%
Wisconsin$5$405268+0.2%
Puerto Rico$5$62442+0.2%
Connecticut$5$45239+0.2%
Maryland$5$4181,0630.0%
North Carolina$5$4483,1840.0%
Tennessee$5$3133300.0%
Texas$5$28164,0000.0%
Alabama$5$4266790.0%
Arizona$5$4531,3390.0%
California$5$45272,4110.0%
Illinois$5$4810521-0.2%
Colorado$5$48794-0.2%
Pennsylvania$5$526515-0.4%
Mississippi$5$42331-0.6%
Iowa$5$2617148-0.9%
Michigan$5$1710104-1.5%

⚠️ 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