88365

Genetic sequencing localization, initial procedure

Medicare pricing data for 6,636 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $40 in Mississippi to $180 in Puerto Rico. 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, initial procedure (HCPCS code 88365) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $76.64, but hospitals typically charge $228.83 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $76.64, your out-of-pocket cost would be approximately $15.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$76.64
Average Hospital Charge
$228.83
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$228.83
Medicare Allowed$76.64
Medicare Payment$61.02

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $61.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$180$182853+134.5%
New Jersey$119$2471352,258+54.7%
Connecticut$110$30890878+44.1%
California$105$21377514,643+36.8%
Arizona$101$1641653,149+31.8%
Florida$89$2424035,237+16.2%
Texas$78$2525155,091+1.7%
New York$77$3015194,579+0.0%
Delaware$75$27012122-1.7%
Nevada$73$1662899-4.3%
Maryland$73$248146955-4.7%
Hawaii$66$15737118-14.2%
Arkansas$64$19172705-16.2%
Virginia$64$2131172,012-16.3%
Massachusetts$62$2232902,594-18.9%
Georgia$62$209118788-19.3%
Washington$62$1631681,244-19.5%
Ohio$61$2113112,916-21.0%
Oklahoma$59$18346209-22.6%
Tennessee$59$178153881-23.0%
New Mexico$58$27739299-24.0%
Minnesota$57$2572471,234-25.3%
Missouri$57$2131501,305-25.5%
Wisconsin$56$324158899-26.3%
Nebraska$56$19758567-26.8%
Kansas$56$27160610-27.1%
Alabama$54$20072370-29.0%
Oregon$54$27571511-29.1%
Indiana$52$17197613-32.1%
Utah$51$17154259-33.8%
Kentucky$50$16550450-34.3%
Colorado$49$20099768-35.9%
North Carolina$49$1821881,798-36.2%
Illinois$47$2282641,784-38.9%
Pennsylvania$47$2803093,286-39.1%
District of Columbia$46$28617145-40.4%
South Carolina$45$23992871-41.0%
Iowa$45$21751440-41.9%
Idaho$44$1331270-42.6%
Rhode Island$43$3591367-43.7%
North Dakota$43$21815129-43.7%
Michigan$42$2232061,463-45.0%
Montana$42$13815148-45.0%
South Dakota$42$228546-45.0%
New Hampshire$42$4171664-45.4%
Maine$42$13416134-45.7%
Vermont$41$2301247-46.0%
Louisiana$41$20356426-46.4%
West Virginia$41$15620126-47.1%
Mississippi$40$16829120-48.0%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber