86901

Blood typing for rh (d) antigen

Medicare pricing data for 854 providers across 42 states

🤖AI Overview

This procedure has a 12.5x markup — hospitals charge $36.71 but Medicare allows only $2.93. Uninsured patients may face bills 12.5 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

Blood typing for rh (d) antigen (HCPCS code 86901) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2.93, but hospitals typically charge $36.71 — a 12.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2.93, your out-of-pocket cost would be approximately $0.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2.93
Average Hospital Charge
$36.71
Markup Ratio
12.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$36.71
Medicare Allowed$2.93
Medicare Payment$2.93

Hospitals charge 12.5x more than what Medicare allows for this procedure. Medicare actually pays $2.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$3$27337+10.9%
Minnesota$3$301865,569+0.7%
California$3$30787,069+0.3%
Florida$3$77296,9030.0%
Georgia$3$456760.0%
Hawaii$3$1736330.0%
Idaho$3$303170.0%
Indiana$3$30131230.0%
Iowa$3$17161660.0%
Kansas$3$42108360.0%
Kentucky$3$113320.0%
Louisiana$3$1291870.0%
Maine$3$644490.0%
Massachusetts$3$44446250.0%
Nebraska$3$134420.0%
Nevada$3$43102850.0%
New Jersey$3$37177,2360.0%
New Mexico$3$3021270.0%
New York$3$58462,2830.0%
Pennsylvania$3$3091,8210.0%
South Dakota$3$236310.0%
Tennessee$3$29102360.0%
Texas$3$37592,8500.0%
Utah$3$1315600.0%
Alabama$3$3989310.0%
Colorado$3$3472940.0%
Connecticut$3$37103390.0%
Maryland$3$25122,382-0.3%
Michigan$3$1714351-0.3%
North Carolina$3$40103,158-0.3%
North Dakota$3$447125-0.3%
Ohio$3$23172,326-0.3%
Oklahoma$3$286739-0.3%
Virginia$3$1053,722-0.3%
Puerto Rico$3$365127-0.3%
Arizona$3$3171,348-0.3%
Oregon$3$1212249-0.7%
Wisconsin$3$30262,034-0.7%
Mississippi$3$197243-1.0%
Washington$3$3211467-1.0%
Illinois$3$3918798-2.0%
South Carolina$3$18643-2.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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