J7199

Hemophilia clotting factor, not otherwise classified

Medicare pricing data for 20 providers across 0 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

Hemophilia clotting factor, not otherwise classified (HCPCS code J7199) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.30, but hospitals typically charge $9.60 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.30, your out-of-pocket cost would be approximately $1.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.30
Average Hospital Charge
$9.60
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$9.60
Medicare Allowed$7.30
Medicare Payment$5.82

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $5.82 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National

⚠️ 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