Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent
Medicare pricing data for 4,139 providers across 44 states
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
Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequent (HCPCS code G0250) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.50, but hospitals typically charge $26.68 — a 3.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.50, your out-of-pocket cost would be approximately $1.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $6.24 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $12 | $67 | 32 | 485 | +36.6% |
| New Jersey | $9 | $26 | 147 | 5,805 | +9.8% |
| New York | $9 | $36 | 161 | 3,536 | +9.1% |
| California | $9 | $27 | 157 | 3,203 | +6.6% |
| Maryland | $9 | $16 | 31 | 882 | +6.2% |
| Connecticut | $9 | $36 | 14 | 177 | +6.1% |
| Rhode Island | $9 | $31 | 4 | 65 | +5.6% |
| Delaware | $9 | $23 | 12 | 986 | +4.0% |
| Colorado | $9 | $29 | 25 | 200 | +3.3% |
| Illinois | $9 | $32 | 411 | 8,076 | +2.8% |
| Pennsylvania | $9 | $26 | 223 | 6,289 | +2.7% |
| Florida | $9 | $21 | 335 | 7,753 | +2.6% |
| Virginia | $9 | $18 | 76 | 1,531 | +2.6% |
| Nevada | $9 | $32 | 53 | 1,241 | +2.2% |
| Wyoming | $9 | $24 | 12 | 218 | +2.1% |
| Michigan | $9 | $23 | 163 | 4,493 | +2.0% |
| Texas | $9 | $23 | 188 | 2,539 | +0.5% |
| Georgia | $9 | $32 | 119 | 3,206 | 0.0% |
| South Dakota | $8 | $9 | 6 | 217 | -0.2% |
| Ohio | $8 | $29 | 58 | 998 | -0.4% |
| Oregon | $8 | $25 | 32 | 294 | -0.7% |
| Arizona | $8 | $22 | 65 | 1,529 | -0.8% |
| Massachusetts | $8 | $36 | 114 | 3,300 | -1.1% |
| Oklahoma | $8 | $22 | 25 | 529 | -1.1% |
| Vermont | $8 | $24 | 8 | 223 | -1.5% |
| Louisiana | $8 | $29 | 99 | 2,726 | -1.6% |
| New Mexico | $8 | $23 | 14 | 386 | -1.6% |
| North Carolina | $8 | $31 | 267 | 3,144 | -2.0% |
| Tennessee | $8 | $22 | 169 | 3,551 | -2.1% |
| Washington | $8 | $23 | 34 | 173 | -2.8% |
| Mississippi | $8 | $25 | 52 | 1,950 | -3.6% |
| West Virginia | $8 | $19 | 54 | 1,517 | -3.6% |
| Arkansas | $8 | $18 | 26 | 370 | -3.6% |
| Nebraska | $8 | $21 | 38 | 678 | -4.0% |
| Alabama | $8 | $18 | 71 | 1,538 | -4.2% |
| Minnesota | $8 | $44 | 43 | 419 | -4.5% |
| Iowa | $8 | $24 | 282 | 14,168 | -4.7% |
| Wisconsin | $8 | $42 | 168 | 3,232 | -4.8% |
| South Carolina | $8 | $25 | 31 | 566 | -5.8% |
| Kansas | $8 | $24 | 64 | 2,390 | -7.3% |
| Utah | $8 | $18 | 20 | 1,060 | -8.2% |
| Missouri | $8 | $23 | 83 | 3,268 | -8.7% |
| Indiana | $8 | $28 | 57 | 1,599 | -9.1% |
| Kentucky | $8 | $27 | 45 | 1,378 | -9.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber