G2023

Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source

Medicare pricing data for 880 providers across 37 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.0 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source (HCPCS code G2023) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $22.99, but hospitals typically charge $69.00 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $22.99, your out-of-pocket cost would be approximately $4.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$22.99
Average Hospital Charge
$69.00
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$69.00
Medicare Allowed$22.99
Medicare Payment$22.99

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $22.99 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Ohio$27$542667+16.0%
Florida$23$544211,569+0.0%
Delaware$23$2849,0440.0%
Idaho$23$301820.0%
Illinois$23$72116378,5370.0%
Indiana$23$5027790.0%
Kansas$23$4712700.0%
Kentucky$23$2751,0990.0%
Louisiana$23$3035,1830.0%
Maryland$23$4663000.0%
Massachusetts$23$6152,4920.0%
Michigan$23$39128470.0%
Mississippi$23$3421,1600.0%
Missouri$23$3351190.0%
Nebraska$23$313880.0%
Nevada$23$4783,6340.0%
New Jersey$23$504357,5780.0%
New York$23$882813,0330.0%
North Carolina$23$72169,0440.0%
North Dakota$23$5022020.0%
Oklahoma$23$13665,9820.0%
Oregon$23$2528010.0%
Pennsylvania$23$371217,4090.0%
South Carolina$23$41410,2350.0%
Tennessee$23$3033580.0%
Texas$23$666135,1640.0%
Virginia$23$3168,2400.0%
Washington$23$3741,2110.0%
Wisconsin$23$6946,8860.0%
Arizona$23$51713,0640.0%
Arkansas$23$4531,1290.0%
California$23$74103415,2090.0%
Colorado$23$5753,9540.0%
Georgia$23$48114,271-0.0%
Alabama$23$7382,498-0.0%
Utah$23$5154,003-0.1%
Puerto Rico$23$283132,339-1.0%

⚠️ 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