0241U

Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected

Medicare pricing data for 9,590 providers across 51 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

Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected (HCPCS code 0241U) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $138.72, but hospitals typically charge $288.21 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $138.72, your out-of-pocket cost would be approximately $27.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$138.72
Average Hospital Charge
$288.21
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$288.21
Medicare Allowed$138.72
Medicare Payment$138.72

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $138.72 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$140$21430764+0.8%
District of Columbia$140$248220+0.8%
Maine$140$2571634+0.8%
Montana$140$28420157+0.8%
New Hampshire$140$17161435+0.8%
Massachusetts$140$538702,452+0.6%
Arkansas$140$26654430+0.6%
Vermont$139$276181,134+0.5%
Connecticut$139$6571441,959+0.5%
New York$139$3475609,822+0.4%
Wyoming$139$25854499+0.4%
Georgia$139$2783717,540+0.4%
Pennsylvania$139$2876416,857+0.4%
Rhode Island$139$31313531+0.4%
California$139$2852623,716+0.4%
Arizona$139$28161380+0.3%
Michigan$139$251105851+0.3%
Minnesota$139$3123401,329+0.3%
West Virginia$139$30287893+0.3%
Florida$139$3073056,344+0.3%
New Jersey$139$2992456,938+0.3%
South Dakota$139$267961,312+0.3%
Texas$139$26938212,491+0.3%
Kentucky$139$219751,172+0.2%
Ohio$139$2723242,061+0.2%
North Carolina$139$2396449,585+0.2%
North Dakota$139$47282952+0.2%
Kansas$139$2741772,008+0.2%
Nebraska$139$19065594+0.1%
Virginia$139$2892975,180+0.1%
Utah$139$1752053,335+0.1%
Iowa$139$2342112,400+0.0%
Colorado$139$2705386,630+0.0%
Illinois$139$2775938,317-0.0%
Oklahoma$139$28992962-0.0%
Louisiana$139$2592394,483-0.1%
Maryland$138$2821304,015-0.3%
Indiana$138$18919372-0.3%
South Carolina$138$27218810,184-0.4%
Missouri$138$343139624-0.5%
Alaska$138$31376507-0.5%
Wisconsin$138$3354224,490-0.5%
Mississippi$138$263711,234-0.7%
Tennessee$138$2692412,071-0.7%
Oregon$137$279136961-1.0%
New Mexico$137$27817536-1.1%
Nevada$137$4011361,781-1.3%
Hawaii$137$25418394-1.5%
Alabama$136$2293525,842-2.0%
Washington$135$2311501,082-2.5%
Idaho$135$22214111-2.8%

⚠️ 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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