Testing for presence of drug, read by direct observation
Medicare pricing data for 19,544 providers across 51 states
This procedure has a 5.1x markup — hospitals charge $61.91 but Medicare allows only $12.17. Uninsured patients may face bills 5.1 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
Testing for presence of drug, read by direct observation (HCPCS code 80305) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.17, but hospitals typically charge $61.91 — a 5.1x 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 $12.17, your out-of-pocket cost would be approximately $2.43. 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 5.1x more than what Medicare allows for this procedure. Medicare actually pays $12.17 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Rhode Island | $12 | $34 | 86 | 665 | +1.2% |
| Vermont | $12 | $43 | 157 | 1,468 | +1.2% |
| Alaska | $12 | $126 | 118 | 2,152 | +1.1% |
| New Jersey | $12 | $134 | 200 | 9,637 | +0.9% |
| North Dakota | $12 | $69 | 28 | 296 | +0.8% |
| Florida | $12 | $76 | 990 | 44,456 | +0.7% |
| Massachusetts | $12 | $60 | 590 | 6,672 | +0.7% |
| Illinois | $12 | $121 | 299 | 6,982 | +0.5% |
| Pennsylvania | $12 | $46 | 972 | 11,989 | +0.5% |
| New Hampshire | $12 | $216 | 131 | 2,551 | +0.4% |
| New York | $12 | $59 | 557 | 19,277 | +0.4% |
| West Virginia | $12 | $40 | 151 | 2,688 | +0.4% |
| California | $12 | $67 | 773 | 28,954 | +0.4% |
| Connecticut | $12 | $55 | 214 | 3,850 | +0.4% |
| Minnesota | $12 | $35 | 149 | 3,925 | +0.3% |
| New Mexico | $12 | $57 | 227 | 4,878 | +0.3% |
| Virginia | $12 | $74 | 485 | 9,749 | +0.3% |
| Colorado | $12 | $68 | 325 | 4,276 | +0.3% |
| Iowa | $12 | $65 | 97 | 831 | +0.2% |
| South Dakota | $12 | $80 | 52 | 794 | +0.2% |
| Wyoming | $12 | $72 | 67 | 7,034 | +0.2% |
| Arizona | $12 | $81 | 417 | 8,436 | +0.2% |
| Louisiana | $12 | $83 | 188 | 9,136 | +0.2% |
| Mississippi | $12 | $45 | 925 | 46,636 | +0.2% |
| Missouri | $12 | $73 | 154 | 4,109 | +0.2% |
| Texas | $12 | $80 | 1,236 | 35,551 | +0.2% |
| North Carolina | $12 | $56 | 988 | 20,383 | +0.1% |
| Wisconsin | $12 | $78 | 188 | 2,698 | +0.1% |
| Kentucky | $12 | $37 | 923 | 19,541 | 0.0% |
| Ohio | $12 | $46 | 790 | 13,262 | 0.0% |
| South Carolina | $12 | $45 | 370 | 7,171 | -0.1% |
| Maryland | $12 | $51 | 188 | 9,437 | -0.2% |
| Nevada | $12 | $74 | 108 | 5,512 | -0.3% |
| Idaho | $12 | $29 | 228 | 2,990 | -0.5% |
| Oregon | $12 | $52 | 434 | 4,318 | -0.5% |
| Delaware | $12 | $53 | 70 | 773 | -0.6% |
| Georgia | $12 | $70 | 744 | 25,716 | -0.6% |
| Hawaii | $12 | $59 | 45 | 280 | -0.6% |
| Montana | $12 | $53 | 105 | 899 | -0.6% |
| Washington | $12 | $48 | 930 | 9,031 | -0.6% |
| Nebraska | $12 | $74 | 60 | 1,708 | -0.7% |
| Tennessee | $12 | $51 | 1,013 | 27,645 | -0.7% |
| Kansas | $12 | $55 | 177 | 4,402 | -0.7% |
| Alabama | $12 | $32 | 442 | 14,682 | -0.7% |
| Oklahoma | $12 | $47 | 373 | 21,230 | -0.8% |
| Michigan | $12 | $49 | 623 | 12,061 | -1.0% |
| Indiana | $12 | $62 | 391 | 5,726 | -1.1% |
| Arkansas | $12 | $40 | 313 | 11,003 | -1.6% |
| Maine | $12 | $35 | 206 | 1,688 | -1.8% |
| Utah | $12 | $91 | 209 | 4,590 | -1.9% |
| District of Columbia | $12 | $42 | 7 | 71 | -2.5% |
⚠️ 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