88364

Genetic sequencing localization, each additional procedure

Medicare pricing data for 4,220 providers across 47 states

🤖AI Overview

Prices vary significantly by location — from $31 in Mississippi to $106 in New Jersey. 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

Genetic sequencing localization, each additional procedure (HCPCS code 88364) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $58.75, but hospitals typically charge $171.92 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $58.75, your out-of-pocket cost would be approximately $11.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$58.75
Average Hospital Charge
$171.92
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$171.92
Medicare Allowed$58.75
Medicare Payment$46.76

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $46.76 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$106$168824,209+79.7%
Connecticut$94$28247725+60.2%
Florida$74$1842623,919+25.8%
Texas$67$2133283,364+13.7%
Nevada$64$1221688+9.6%
New York$64$2153342,794+8.4%
California$57$14450810,483-2.6%
Arizona$56$1561361,240-5.3%
Massachusetts$53$1611781,328-10.5%
Washington$52$149103760-11.7%
Maryland$51$17379366-12.8%
Oklahoma$51$15637124-14.0%
Arkansas$50$12757535-15.4%
Wisconsin$49$209100473-15.8%
Georgia$49$13865476-16.3%
Ohio$49$2152081,909-16.3%
Tennessee$49$16295361-17.1%
Kansas$48$16530416-17.7%
Utah$47$1542498-19.8%
Missouri$46$13792945-21.4%
New Mexico$45$20230215-22.7%
Nebraska$45$16248452-23.2%
Alabama$44$8851193-24.6%
Virginia$44$173821,639-24.7%
Minnesota$43$198130578-27.2%
Indiana$42$15973413-28.1%
Oregon$42$16748383-28.9%
Kentucky$40$13917129-31.3%
Pennsylvania$37$2242052,070-36.6%
District of Columbia$37$83655-37.9%
North Carolina$36$145118979-38.1%
Colorado$36$12660444-38.2%
Iowa$36$13943351-39.3%
North Dakota$34$9613102-41.6%
South Carolina$34$16472623-41.9%
Illinois$34$1461441,157-42.1%
New Hampshire$34$107326-42.7%
Delaware$34$149880-42.8%
Hawaii$34$96843-43.0%
Michigan$34$201135699-43.0%
South Dakota$33$134340-43.2%
Montana$33$941064-43.5%
Maine$33$7913119-44.0%
Louisiana$33$10839326-44.6%
Idaho$32$81732-45.2%
West Virginia$32$2051483-45.6%
Mississippi$31$1362394-46.6%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber