88121

Cell examination of urine, computer-assisted

Medicare pricing data for 323 providers across 22 states

🤖AI Overview

Prices vary significantly by location — from $45 in Georgia to $488 in Maryland. Where you get this procedure matters more than almost any other factor. 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 urine, computer-assisted (HCPCS code 88121) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $377.86, but hospitals typically charge $1,061 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$75.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $377.86, your out-of-pocket cost would be approximately $75.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$377.86
Average Hospital Charge
$1,061
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,060.95
Medicare Allowed$377.86
Medicare Payment$299.72

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $299.72 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$488$1,956101,839+29.1%
Pennsylvania$444$1,024102,972+17.4%
Virginia$437$1,047102,774+15.6%
Nevada$418$871147+10.5%
Michigan$407$1,30291,966+7.6%
Texas$385$1,11214224+1.9%
California$369$1,148361,270-2.5%
New Jersey$365$1,109182,248-3.3%
Tennessee$360$959191,366-4.7%
Utah$360$1,096439-4.8%
Arkansas$354$1,0822377-6.4%
Ohio$345$5616916-8.8%
Indiana$343$91817464-9.4%
Florida$341$758361,244-9.8%
Illinois$333$1,3058901-11.8%
New York$320$792242,357-15.2%
Washington$233$58025207-38.4%
Connecticut$52$299344-86.3%
Massachusetts$50$21114100-86.8%
Arizona$46$271240-87.8%
Louisiana$45$99246-88.0%
Georgia$45$1699438-88.2%

⚠️ 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