81002

Urinalysis, manual test

Medicare pricing data for 97,606 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 2.4 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

Urinalysis, manual test (HCPCS code 81002) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3.39, but hospitals typically charge $14.81 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3.39, your out-of-pocket cost would be approximately $0.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3.39
Average Hospital Charge
$14.81
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$14.81
Medicare Allowed$3.39
Medicare Payment$3.39

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $3.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
South Dakota$3$1840627+0.9%
Massachusetts$3$163,40557,907+0.6%
Puerto Rico$3$14840+0.6%
Florida$3$136,996211,606+0.3%
Illinois$3$203,65453,594+0.3%
New Hampshire$3$206406,924+0.3%
New Jersey$3$143,678115,311+0.3%
New York$3$186,080254,842+0.3%
North Dakota$3$14551,090+0.3%
Oklahoma$3$1499817,300+0.3%
Pennsylvania$3$125,431101,421+0.3%
South Carolina$3$161,28556,235+0.3%
Texas$3$155,934146,827+0.3%
Vermont$3$152053,509+0.3%
California$3$168,763202,225+0.3%
Connecticut$3$151,73634,545+0.3%
Delaware$3$103297,5760.0%
Georgia$3$163,22591,0620.0%
Idaho$3$125167,3750.0%
Indiana$3$152,48735,2420.0%
Iowa$3$154828,6550.0%
Kansas$3$1387923,4720.0%
Kentucky$3$141,56229,1510.0%
Montana$3$153013,4290.0%
Nebraska$3$133547,6090.0%
North Carolina$3$162,87171,4750.0%
Ohio$3$145,21789,1230.0%
Rhode Island$3$125566,0080.0%
Utah$3$1054711,4700.0%
Virginia$3$132,54882,4980.0%
West Virginia$3$165469,4410.0%
Wyoming$3$131736,8730.0%
Alaska$3$312742,5550.0%
Arizona$3$112,99495,5890.0%
Colorado$3$131,73729,0610.0%
District of Columbia$3$133074,316-0.3%
Louisiana$3$1491620,217-0.3%
Maine$3$183293,128-0.3%
Maryland$3$142,21170,202-0.3%
Michigan$3$113,08466,441-0.3%
Mississippi$3$1761723,158-0.3%
Missouri$3$131,74835,213-0.3%
Nevada$3$151,09128,292-0.3%
New Mexico$3$1867514,426-0.3%
Oregon$3$141,18619,168-0.3%
Washington$3$142,47333,680-0.3%
Wisconsin$3$2876012,748-0.3%
Arkansas$3$1371119,550-0.3%
Minnesota$3$193986,783-0.6%
Tennessee$3$162,34771,428-0.6%
Alabama$3$101,80655,835-0.6%
Hawaii$3$113586,804-1.8%

⚠️ 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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