86905

Blood typing for red blood cell antigens

Medicare pricing data for 86 providers across 15 states

🤖AI Overview

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 red blood cell antigens (HCPCS code 86905) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3.75, but hospitals typically charge $6.78 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3.75, your out-of-pocket cost would be approximately $0.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3.75
Average Hospital Charge
$6.78
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$6.78
Medicare Allowed$3.75
Medicare Payment$3.75

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $3.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$4$861360+1.3%
Minnesota$4$689231+0.8%
Florida$4$10342090.0%
Illinois$4$5236,6820.0%
Maryland$4$355700.0%
Massachusetts$4$392210.0%
New Jersey$4$883290.0%
New Mexico$4$771110.0%
New York$4$352720.0%
North Carolina$4$1022570.0%
Ohio$4$234920.0%
Texas$4$596420.0%
Virginia$4$112310.0%
Alabama$4$943180.0%
Arizona$4$952350.0%

⚠️ 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