88321

Surgical pathology consultation and report on referred slides prepared elsewhere

Medicare pricing data for 7,210 providers across 50 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

Surgical pathology consultation and report on referred slides prepared elsewhere (HCPCS code 88321) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $90.78, but hospitals typically charge $321.57 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.16

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $90.78, your out-of-pocket cost would be approximately $18.16. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$90.78
Average Hospital Charge
$321.57
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$321.57
Medicare Allowed$90.78
Medicare Payment$70.37

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $70.37 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$107$399333+18.0%
California$101$26173731,798+11.3%
Maryland$98$3271276,316+8.3%
Connecticut$97$2931122,488+7.4%
Idaho$94$1754514+3.5%
New York$93$40870218,989+2.4%
Minnesota$93$4972053,422+2.1%
Washington$92$2521723,847+1.4%
Nevada$92$2961789+1.0%
New Jersey$91$3461691,502+0.6%
Colorado$91$340841,292-0.1%
Arizona$90$4721302,391-0.4%
Massachusetts$90$33740110,801-0.7%
District of Columbia$90$25021139-1.3%
North Dakota$89$285963-1.4%
Hawaii$89$17834112-1.8%
Missouri$89$2891323,132-2.0%
Oregon$89$329671,417-2.1%
Rhode Island$88$40720240-2.6%
Illinois$88$4033054,490-2.7%
Ohio$88$2573616,096-2.8%
Utah$88$229821,694-3.0%
Florida$88$34239012,285-3.4%
Oklahoma$87$31565336-4.2%
Virginia$86$3331482,711-5.0%
New Mexico$86$38833370-5.2%
Pennsylvania$86$2784067,425-5.5%
Wisconsin$86$3951482,231-5.6%
Louisiana$85$25056356-6.0%
Texas$85$31540512,512-6.3%
Delaware$84$2671866-7.4%
Georgia$84$3821381,190-7.5%
South Dakota$84$29025553-7.8%
New Hampshire$84$48146410-7.8%
Michigan$84$3382886,103-8.0%
Indiana$83$2211141,588-8.1%
South Carolina$83$324871,667-8.3%
North Carolina$83$2481853,390-9.1%
Iowa$83$341911,533-9.1%
Tennessee$82$3901863,199-9.6%
Montana$82$2491119-9.8%
Alabama$82$24176737-10.1%
Mississippi$81$29338393-10.9%
Kentucky$81$285891,425-11.1%
Maine$81$27227120-11.2%
Arkansas$80$20662804-12.2%
West Virginia$80$22821228-12.2%
Kansas$79$219631,247-12.5%
Nebraska$78$30339963-13.8%
Vermont$77$42735382-14.9%

⚠️ 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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