Phenytoin level, total
Medicare pricing data for 861 providers across 47 states
This procedure has a 5.8x markup — hospitals charge $75.48 but Medicare allows only $12.97. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. 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
Phenytoin level, total (HCPCS code 80185) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.97, but hospitals typically charge $75.48 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.97, your out-of-pocket cost would be approximately $2.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $12.97 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Delaware | $13 | $26 | 2 | 57 | +0.1% |
| Florida | $13 | $63 | 33 | 4,161 | +0.1% |
| Georgia | $13 | $84 | 11 | 1,663 | +0.1% |
| Idaho | $13 | $62 | 4 | 41 | +0.1% |
| Indiana | $13 | $60 | 10 | 206 | +0.1% |
| Iowa | $13 | $54 | 9 | 164 | +0.1% |
| Kansas | $13 | $117 | 10 | 1,605 | +0.1% |
| Louisiana | $13 | $54 | 20 | 1,244 | +0.1% |
| Maine | $13 | $42 | 2 | 68 | +0.1% |
| Maryland | $13 | $71 | 8 | 714 | +0.1% |
| Missouri | $13 | $35 | 9 | 187 | +0.1% |
| Nebraska | $13 | $45 | 4 | 43 | +0.1% |
| New Hampshire | $13 | $89 | 10 | 35 | +0.1% |
| New Jersey | $13 | $92 | 18 | 4,123 | +0.1% |
| New Mexico | $13 | $72 | 1 | 103 | +0.1% |
| New York | $13 | $96 | 15 | 1,119 | +0.1% |
| North Dakota | $13 | $57 | 7 | 105 | +0.1% |
| Ohio | $13 | $68 | 21 | 3,821 | +0.1% |
| Oregon | $13 | $54 | 6 | 175 | +0.1% |
| Pennsylvania | $13 | $94 | 16 | 811 | +0.1% |
| Rhode Island | $13 | $56 | 1 | 90 | +0.1% |
| South Dakota | $13 | $74 | 7 | 161 | +0.1% |
| Utah | $13 | $28 | 9 | 96 | +0.1% |
| Virginia | $13 | $48 | 21 | 806 | +0.1% |
| West Virginia | $13 | $110 | 4 | 16 | +0.1% |
| Puerto Rico | $13 | $17 | 17 | 33 | +0.1% |
| Arizona | $13 | $88 | 25 | 685 | +0.1% |
| Illinois | $13 | $73 | 61 | 2,300 | 0.0% |
| Mississippi | $13 | $49 | 12 | 448 | 0.0% |
| Nevada | $13 | $45 | 4 | 997 | 0.0% |
| North Carolina | $13 | $90 | 16 | 4,022 | 0.0% |
| Oklahoma | $13 | $46 | 11 | 1,035 | 0.0% |
| California | $13 | $77 | 50 | 4,125 | 0.0% |
| Arkansas | $13 | $22 | 10 | 562 | -0.1% |
| Kentucky | $13 | $28 | 22 | 436 | -0.2% |
| Massachusetts | $13 | $80 | 59 | 1,739 | -0.2% |
| Alabama | $13 | $82 | 10 | 1,493 | -0.2% |
| Colorado | $13 | $79 | 8 | 344 | -0.2% |
| Minnesota | $13 | $85 | 82 | 328 | -0.2% |
| Tennessee | $13 | $63 | 75 | 825 | -0.2% |
| Wisconsin | $13 | $103 | 13 | 512 | -0.3% |
| Michigan | $13 | $34 | 18 | 485 | -0.4% |
| Texas | $13 | $83 | 61 | 4,449 | -0.4% |
| South Carolina | $13 | $30 | 7 | 155 | -0.5% |
| Hawaii | $13 | $46 | 2 | 62 | -0.8% |
| Washington | $13 | $91 | 22 | 627 | -0.8% |
| Connecticut | $13 | $70 | 4 | 118 | -1.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber