88368

Microscopic genetic analysis of tissue, manual, initial procedure

Medicare pricing data for 1,006 providers across 38 states

🤖AI Overview

Prices vary significantly by location — from $39 in Arkansas to $143 in Connecticut. 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

Microscopic genetic analysis of tissue, manual, initial procedure (HCPCS code 88368) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $76.17, but hospitals typically charge $358.48 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.23

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $76.17, your out-of-pocket cost would be approximately $15.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$76.17
Average Hospital Charge
$358.48
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$358.48
Medicare Allowed$76.17
Medicare Payment$60.44

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $60.44 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$143$5117614+87.5%
New Jersey$126$634111,747+65.0%
New York$116$528692,365+52.4%
Nevada$93$18615167+21.7%
Texas$82$313952,108+7.8%
California$80$401952,191+4.9%
Illinois$69$32079536-9.3%
Georgia$53$25512976-30.1%
South Carolina$53$3128103-30.9%
Iowa$49$2332764-35.7%
Wisconsin$48$36538166-37.0%
Kentucky$47$20015138-37.9%
Ohio$46$16528144-39.5%
Virginia$45$26526901-40.4%
Washington$44$11719444-42.1%
Arizona$44$12839411-42.3%
Hawaii$43$238844-43.0%
Massachusetts$43$22933758-43.0%
Maryland$42$317354-44.4%
Oregon$42$37924257-44.6%
Michigan$42$2031277-45.1%
Pennsylvania$42$22035127-45.3%
Florida$42$28549413-45.5%
New Mexico$42$358237-45.5%
Rhode Island$41$2721142-45.6%
Utah$41$1801755-45.6%
Missouri$41$23134548-45.7%
Indiana$41$172658-46.1%
Louisiana$41$1161254-46.5%
Minnesota$40$41112353-47.0%
Tennessee$40$21141454-47.1%
Maine$40$118350-47.5%
Vermont$40$219123-47.8%
North Carolina$40$2071366-47.8%
Kansas$40$19324650-48.1%
Idaho$39$112425-48.2%
Nebraska$39$1231029-48.6%
Arkansas$39$248521-49.2%

⚠️ 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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