89055

White blood cell measure, stool specimen

Medicare pricing data for 675 providers across 37 states

🤖AI Overview

This procedure has a 12.0x markup — hospitals charge $50.27 but Medicare allows only $4.18. Uninsured patients may face bills 12.0 times higher than what insurance negotiates. 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

White blood cell measure, stool specimen (HCPCS code 89055) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.18, but hospitals typically charge $50.27 — a 12.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.18, your out-of-pocket cost would be approximately $0.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.18
Average Hospital Charge
$50.27
Markup Ratio
12.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$50.27
Medicare Allowed$4.18
Medicare Payment$4.18

Hospitals charge 12.0x more than what Medicare allows for this procedure. Medicare actually pays $4.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Mississippi$4$456284+2.4%
Puerto Rico$4$55793+1.0%
New York$4$2449354+0.2%
Florida$4$62303,7160.0%
Georgia$4$555180.0%
Illinois$4$63134590.0%
Iowa$4$369240.0%
Kansas$4$45111240.0%
Louisiana$4$484510.0%
Maryland$4$67284170.0%
Massachusetts$4$5669650.0%
Michigan$4$204360.0%
Minnesota$4$26821190.0%
Missouri$4$68217150.0%
Nebraska$4$151380.0%
Nevada$4$5632230.0%
New Hampshire$4$1427530.0%
North Carolina$4$55205,1780.0%
Oregon$4$289660.0%
Rhode Island$4$201590.0%
South Carolina$4$82190.0%
South Dakota$4$269330.0%
Tennessee$4$40125040.0%
Texas$4$55353,8830.0%
Virginia$4$34799240.0%
Arizona$4$55151,4800.0%
Arkansas$4$246120.0%
California$4$54262,6790.0%
Colorado$4$6461380.0%
New Jersey$4$38126,709-0.2%
Oklahoma$4$494510-0.2%
Pennsylvania$4$5215433-0.2%
Washington$4$548537-0.2%
Alabama$4$46352,273-0.2%
Ohio$4$546887-0.5%
Indiana$4$32298-1.0%
Maine$4$14236-1.4%

⚠️ 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