88381

Preparation of specimen, manual

Medicare pricing data for 794 providers across 34 states

🤖AI Overview

Prices vary significantly by location — from $21 in West Virginia to $216 in California. 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

Preparation of specimen, manual (HCPCS code 88381) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $161.13, but hospitals typically charge $240.44 — a 1.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$32.23

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $161.13, your out-of-pocket cost would be approximately $32.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$161.13
Average Hospital Charge
$240.44
Markup Ratio
1.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$240.44
Medicare Allowed$161.13
Medicare Payment$126.49

Hospitals charge 1.5x more than what Medicare allows for this procedure. Medicare actually pays $126.49 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$216$3275323,595+34.0%
Alaska$203$272118+26.2%
Illinois$191$244364,247+18.5%
Utah$187$21988,370+15.8%
Arizona$151$1691021,467-6.0%
Oklahoma$127$347460-21.0%
Florida$123$334392,334-23.6%
Pennsylvania$102$212291,341-36.6%
New Jersey$90$284201,980-44.0%
New York$83$30718342-48.3%
Washington$69$12669663-57.4%
Texas$68$23693826-58.0%
Tennessee$58$186761,844-63.8%
Massachusetts$55$205501,712-66.0%
Minnesota$47$141611,480-70.7%
Connecticut$47$32012120-70.8%
Ohio$32$16423157-80.1%
Oregon$27$8227468-83.0%
Iowa$26$1777637-83.7%
Missouri$26$21012132-83.8%
Michigan$25$17426395-84.4%
Wisconsin$24$2311244-85.2%
District of Columbia$24$179126-85.3%
Indiana$24$14919115-85.4%
Colorado$23$805204-85.4%
Maryland$23$129943-85.5%
Georgia$23$181273-85.8%
Maine$23$7512218-85.8%
Mississippi$23$54316-85.8%
North Carolina$23$1816237-85.9%
Kentucky$22$103418-86.1%
Nebraska$22$130433-86.1%
Arkansas$22$53640-86.5%
West Virginia$21$400432-86.8%

⚠️ 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