88104

Cell examination of body fluid, smears

Medicare pricing data for 2,903 providers across 48 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

Cell examination of body fluid, smears (HCPCS code 88104) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $31.72, but hospitals typically charge $122.76 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.34

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $31.72, your out-of-pocket cost would be approximately $6.34. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$31.72
Average Hospital Charge
$122.76
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$122.76
Medicare Allowed$31.72
Medicare Payment$24.64

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $24.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$48$541589+49.8%
New York$47$1641882,856+46.7%
New Jersey$46$18192916+45.8%
Texas$41$1502492,197+29.6%
Georgia$36$9159468+14.7%
Maryland$32$100661,430+1.8%
California$32$1234144,911+0.4%
Connecticut$31$11238275-1.4%
Nevada$30$12739187-5.0%
Tennessee$29$12477896-7.5%
Minnesota$29$10941314-7.8%
District of Columbia$29$291658-8.1%
Washington$29$8128413-9.1%
Ohio$29$1061211,328-9.8%
North Carolina$28$10570408-10.3%
New Hampshire$28$158726-11.6%
Massachusetts$28$121851,349-12.4%
Florida$28$1232091,736-13.3%
Delaware$27$120725-13.7%
Hawaii$27$781640-13.8%
North Dakota$27$128898-13.8%
Pennsylvania$27$1141251,065-15.3%
Colorado$27$10223241-15.7%
Montana$27$721054-16.0%
Nebraska$27$102831-16.1%
Illinois$27$1381351,014-16.1%
Michigan$26$77761,098-16.9%
Maine$26$8717242-17.0%
Oregon$26$75921-17.2%
Arizona$26$9927687-17.2%
Vermont$26$136663-17.3%
Oklahoma$26$8319299-17.6%
New Mexico$26$85518-17.6%
Kansas$26$10331197-18.2%
Virginia$26$13048181-18.2%
Wisconsin$26$27352617-18.2%
Utah$26$1101158-18.9%
Mississippi$26$11219117-18.9%
Alabama$26$80611,324-19.3%
South Carolina$26$8042472-19.3%
Louisiana$26$9542219-19.5%
West Virginia$25$13314160-19.6%
Iowa$25$8927332-19.9%
Idaho$25$217723-19.9%
Indiana$25$10854576-19.9%
Missouri$25$10962699-19.9%
Kentucky$25$9034270-20.0%
Arkansas$25$5629194-21.4%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber