88185

Flow cytometry technique for dna or cell analysis, each additional marker

Medicare pricing data for 1,441 providers across 46 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 2.0 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Flow cytometry technique for dna or cell analysis, each additional marker (HCPCS code 88185) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $25.00, but hospitals typically charge $103.86 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.00

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $25.00, your out-of-pocket cost would be approximately $5.00. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$25.00
Average Hospital Charge
$103.86
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$103.86
Medicare Allowed$25.00
Medicare Payment$19.85

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $19.85 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$29$1751586+16.2%
New York$29$112151313,970+15.3%
Maryland$28$1305230,286+14.0%
Massachusetts$28$8551,890+13.1%
New Jersey$28$12035268,264+10.2%
California$27$9079230,373+8.4%
Virginia$26$106111104,945+3.6%
Connecticut$26$844125,075+3.4%
Hawaii$26$78122,384+2.6%
Rhode Island$25$10331,066-1.3%
Colorado$24$1654613,829-2.0%
Washington$24$814823,766-2.5%
Minnesota$24$11713517,718-3.7%
Illinois$24$1243130,427-4.3%
Missouri$24$93127,471-4.5%
Puerto Rico$24$2410977-5.5%
Florida$24$10832249,634-5.7%
Maine$24$9422,072-5.7%
Nevada$24$62310,569-5.9%
South Dakota$24$1065705-6.0%
Wisconsin$23$151126,061-7.4%
Pennsylvania$23$10595,386-7.9%
Michigan$23$88327,714-9.1%
Texas$23$92221205,763-9.7%
Nebraska$22$69186,538-12.2%
Montana$22$941299-12.3%
Oregon$22$92154,145-12.6%
North Dakota$22$1303190-12.8%
Indiana$22$112207,257-12.9%
South Carolina$22$116289,241-13.6%
Kansas$22$168408,941-13.6%
West Virginia$21$31111,017-14.1%
Ohio$21$731611,371-14.3%
Arizona$21$993062,371-14.3%
Iowa$21$1303912-14.4%
New Mexico$21$8522,936-14.5%
Mississippi$21$704598-15.8%
Oklahoma$21$71169,697-16.0%
Louisiana$21$753633-16.5%
Alabama$20$1335428,890-18.1%
Utah$20$66104,410-18.4%
North Carolina$20$741268,176-19.4%
Georgia$20$1131913,474-20.0%
Kentucky$20$622325-20.1%
Arkansas$20$872719,738-20.6%
Tennessee$19$10763108,692-22.2%

⚠️ 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