J3590

Unclassified biologics

Medicare pricing data for 2,066 providers across 44 states

🤖AI Overview

Prices vary significantly by location — from $19 in Wisconsin to $4,535 in Maine. 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

Unclassified biologics (HCPCS code J3590) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $278.16, but hospitals typically charge $670.90 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$55.63

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $278.16, your out-of-pocket cost would be approximately $55.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$278.16
Average Hospital Charge
$670.90
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$670.90
Medicare Allowed$278.16
Medicare Payment$220.70

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $220.70 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maine$4,535$11,3251026+1530.5%
Mississippi$3,825$9,65318147+1275.3%
Colorado$3,584$8,60037352+1188.6%
North Carolina$3,170$8,94437597+1039.7%
Alabama$3,057$8,562332+999.1%
New Jersey$2,862$6,063691,970+928.9%
New Hampshire$2,786$3,8998217+901.7%
Virginia$2,769$6,52229891+895.4%
Georgia$2,755$7,03233257+890.5%
Hawaii$2,660$5,300215+856.5%
District of Columbia$2,656$9,100128+854.9%
Nevada$2,615$4,8639360+840.1%
Massachusetts$2,615$5,16335332+840.0%
Pennsylvania$2,606$5,72863696+837.0%
Connecticut$2,542$4,11112420+813.8%
Arkansas$2,245$5,17712122+707.1%
South Carolina$2,115$3,06614209+660.3%
Texas$2,037$6,0821474,339+632.2%
New Mexico$1,923$3,12415463+591.4%
North Dakota$1,912$2,441532+587.3%
Maryland$1,850$4,509582,359+565.2%
New York$1,703$3,6831001,837+512.1%
South Dakota$1,645$1,9337257+491.2%
Illinois$1,273$2,673631,386+357.5%
Oregon$1,199$2,47419230+331.0%
Tennessee$722$1,980481,059+159.4%
Florida$695$2,1462848,842+149.8%
Idaho$638$1,136646+129.4%
Louisiana$512$1,197141,916+84.0%
Washington$490$1,16125643+76.2%
Arizona$408$1,26227816+46.8%
Minnesota$255$600494,258-8.4%
Missouri$251$569603,618-9.9%
Iowa$148$248429,089-46.7%
Michigan$128$30113520,226-53.9%
Kansas$126$414275,214-54.8%
Ohio$124$33414732,980-55.4%
Nebraska$91$183236,293-67.5%
Indiana$87$1525820,529-68.8%
Rhode Island$86$1146618-69.0%
Kentucky$79$1636811,111-71.5%
Utah$63$79171,623-77.3%
California$57$11720270,935-79.6%
Wisconsin$19$39812,557-93.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber