G0472

Hepatitis c antibody screening, for individual at high risk and other covered indication(s)

Medicare pricing data for 3,541 providers across 44 states

🤖AI Overview

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

Hepatitis c antibody screening, for individual at high risk and other covered indication(s) (HCPCS code G0472) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $44.86, but hospitals typically charge $113.83 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $44.86, your out-of-pocket cost would be approximately $8.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$44.86
Average Hospital Charge
$113.83
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$113.83
Medicare Allowed$44.86
Medicare Payment$44.86

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $44.86 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$45$602378+1.2%
Maine$45$9870528+1.2%
Maryland$45$14951,968+1.2%
Nevada$45$1495734+1.2%
New Hampshire$45$10234121+1.2%
Virginia$45$88994,039+1.2%
Colorado$45$92444,832+1.2%
Kansas$45$13756,611+1.2%
New Jersey$45$1249116,958+1.2%
Iowa$45$621101,993+1.2%
North Carolina$45$1135420,380+1.2%
Pennsylvania$45$141241,937+1.2%
Michigan$45$476495+1.2%
Indiana$45$50151,657+1.2%
Oklahoma$45$78193,591+1.2%
Tennessee$45$832786,937+1.2%
Ohio$45$881589,319+1.1%
Georgia$45$147315,932+1.1%
Louisiana$45$938586+1.1%
Illinois$45$1501575,000+1.1%
Wisconsin$45$108795,541+1.0%
Connecticut$45$55141744+1.0%
Arkansas$45$6838358+1.0%
Florida$45$14016213,098+0.9%
New York$45$811331,356+0.8%
North Dakota$45$1289336+0.8%
Rhode Island$45$62357+0.8%
Kentucky$45$6771,544+0.6%
California$45$1335120,438+0.6%
Massachusetts$45$1383145,835+0.3%
South Dakota$45$11813308+0.3%
South Carolina$45$8737569+0.2%
Nebraska$45$5624210-0.0%
Oregon$45$71803,039-0.1%
Mississippi$45$964281-0.2%
Texas$45$12921318,262-0.3%
Washington$45$9828511,862-0.4%
Minnesota$44$1064692,847-2.9%
Arizona$43$1011919,258-4.6%
Montana$42$644151-6.6%
Alabama$41$93109,192-8.7%
Missouri$39$7533295-12.6%
Utah$37$41322-18.4%
Idaho$35$38847-20.9%

⚠️ 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

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