88291

Interpretation and report of genetic testing

Medicare pricing data for 502 providers across 37 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

Interpretation and report of genetic testing (HCPCS code 88291) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $33.41, but hospitals typically charge $115.28 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $33.41, your out-of-pocket cost would be approximately $6.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$33.41
Average Hospital Charge
$115.28
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$115.28
Medicare Allowed$33.41
Medicare Payment$26.35

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $26.35 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$36$117340+7.4%
New York$36$201384,484+6.9%
Washington$35$582941+5.9%
California$35$644516,919+4.9%
Massachusetts$35$125131,784+4.3%
Delaware$34$85214+2.8%
New Jersey$34$187155,043+2.4%
Connecticut$34$120101,089+2.1%
Oregon$34$1452449+1.1%
Illinois$33$9214928-0.4%
Pennsylvania$33$157121,005-0.5%
Nebraska$33$22941,434-2.2%
Colorado$33$881578-2.2%
Florida$32$74577,946-3.0%
Texas$32$160574,053-3.5%
Michigan$32$1275212-4.0%
North Dakota$32$161356-4.2%
Minnesota$32$214412,995-4.3%
Virginia$32$9315934-4.5%
Maine$32$165540-4.5%
Vermont$32$1662186-5.1%
Missouri$32$1339469-5.4%
Utah$31$838116-5.8%
Arizona$31$816651-6.1%
Wisconsin$31$16816153-6.6%
Georgia$31$13611399-7.1%
Ohio$31$7010325-7.2%
New Mexico$31$1339122-7.6%
South Carolina$31$1814352-8.0%
North Carolina$31$92152,170-8.1%
West Virginia$31$854317-8.2%
Kentucky$30$545113-9.1%
Iowa$30$2524446-9.3%
Tennessee$30$63202,392-9.6%
Louisiana$30$72895-9.7%
Alabama$30$322161-11.5%
Arkansas$30$8231,076-11.6%

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

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