80307

Testing for presence of drug, by chemistry analyzers

Medicare pricing data for 7,444 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 2.0 million services annually. Even small pricing inefficiencies here affect millions of patients. 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, by chemistry analyzers (HCPCS code 80307) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $60.31, but hospitals typically charge $217.78 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $60.31, your out-of-pocket cost would be approximately $12.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$60.31
Average Hospital Charge
$217.78
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$217.78
Medicare Allowed$60.31
Medicare Payment$60.31

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $60.31 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$61$197288+1.0%
Puerto Rico$61$5902156+1.0%
District of Columbia$61$1873708+0.9%
Montana$61$190101,314+0.9%
West Virginia$61$141554,707+0.8%
North Dakota$61$164239,002+0.7%
California$61$162217175,846+0.7%
Massachusetts$61$17120280,276+0.6%
Florida$61$273610114,439+0.5%
Connecticut$61$157608,877+0.5%
New York$61$23127345,171+0.5%
Rhode Island$61$341926,612+0.5%
New Jersey$61$42711594,512+0.5%
Pennsylvania$61$24512370,360+0.4%
Arkansas$61$20813130,327+0.4%
Illinois$61$20910631,842+0.4%
Maine$61$1125406+0.4%
Vermont$61$200181,983+0.3%
North Carolina$60$152569222,923+0.2%
Maryland$60$24121066,720+0.1%
Mississippi$60$17912637,514+0.1%
Georgia$60$230287101,061+0.1%
Minnesota$60$19622911,586+0.1%
Michigan$60$16116641,531+0.0%
Wisconsin$60$27111210,339+0.0%
Idaho$60$173373,5760.0%
Nevada$60$35014340,4020.0%
New Mexico$60$225323,504-0.1%
Delaware$60$244336,598-0.2%
Iowa$60$241381,563-0.2%
Tennessee$60$219370123,616-0.3%
Oklahoma$60$18018763,270-0.3%
Arizona$60$22429830,660-0.4%
Louisiana$60$23412327,054-0.4%
South Dakota$60$1897158-0.4%
Texas$60$272700182,136-0.5%
Washington$60$17618737,552-0.5%
Virginia$60$19712115,833-0.5%
Kentucky$60$15338581,440-0.5%
Missouri$60$1906010,027-0.7%
South Carolina$60$21220731,999-0.7%
Ohio$60$14321332,130-0.7%
Alaska$60$272264,253-0.8%
Colorado$60$1987012,735-0.8%
Indiana$60$16316041,814-0.9%
Kansas$60$1772212,570-0.9%
Oregon$60$2446512,297-1.0%
Hawaii$60$18682,390-1.1%
Alabama$59$17219541,072-1.6%
New Hampshire$59$278386,066-1.7%
Nebraska$59$241131,314-1.8%
Utah$59$124316,373-2.7%

⚠️ 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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