Dna testing for genetic defects
Medicare pricing data for 171 providers across 31 states
This procedure has a 5.5x markup — hospitals charge $114.49 but Medicare allows only $20.98. Uninsured patients may face bills 5.5 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
Dna testing for genetic defects (HCPCS code 88271) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.98, but hospitals typically charge $114.49 — a 5.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.98, your out-of-pocket cost would be approximately $4.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.5x more than what Medicare allows for this procedure. Medicare actually pays $20.98 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Connecticut | $21 | $131 | 3 | 11,731 | +0.1% |
| Hawaii | $21 | $83 | 2 | 149 | +0.0% |
| Iowa | $21 | $88 | 2 | 125 | +0.0% |
| Kansas | $21 | $102 | 2 | 810 | +0.0% |
| Maryland | $21 | $101 | 5 | 1,614 | +0.0% |
| Massachusetts | $21 | $95 | 2 | 380 | +0.0% |
| Michigan | $21 | $53 | 3 | 241 | +0.0% |
| Minnesota | $21 | $85 | 31 | 4,528 | +0.0% |
| Nevada | $21 | $115 | 1 | 600 | +0.0% |
| New Jersey | $21 | $128 | 3 | 1,977 | +0.0% |
| New York | $21 | $132 | 5 | 2,269 | +0.0% |
| Oklahoma | $21 | $108 | 3 | 183 | +0.0% |
| Pennsylvania | $21 | $95 | 5 | 2,107 | +0.0% |
| Tennessee | $21 | $150 | 2 | 8,484 | +0.0% |
| Utah | $21 | $40 | 7 | 96 | +0.0% |
| Virginia | $21 | $108 | 4 | 234 | +0.0% |
| Washington | $21 | $151 | 4 | 1,702 | +0.0% |
| Wisconsin | $21 | $148 | 8 | 428 | +0.0% |
| Alabama | $21 | $44 | 2 | 1,420 | +0.0% |
| Arizona | $21 | $147 | 5 | 7,599 | +0.0% |
| Colorado | $21 | $137 | 4 | 480 | +0.0% |
| North Carolina | $21 | $159 | 5 | 4,050 | -0.0% |
| California | $21 | $113 | 9 | 1,678 | -0.0% |
| Texas | $21 | $61 | 14 | 13,029 | -0.1% |
| Florida | $21 | $102 | 10 | 1,301 | -0.1% |
| Ohio | $21 | $97 | 8 | 658 | -0.3% |
| Indiana | $21 | $68 | 4 | 268 | -0.4% |
| Georgia | $21 | $99 | 2 | 332 | -0.5% |
| Illinois | $21 | $158 | 6 | 364 | -1.0% |
| Maine | $21 | $106 | 1 | 126 | -1.3% |
| Missouri | $20 | $135 | 1 | 140 | -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.
💊 Need post-procedure medications? Check costs on OpenPrescriber