81185

Gene analysis (calcium voltage-gated channel subunit alpha1 a) of full sequence

Medicare pricing data for 39 providers across 8 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

Gene analysis (calcium voltage-gated channel subunit alpha1 a) of full sequence (HCPCS code 81185) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $822.71, but hospitals typically charge $896.06 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$164.54

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $822.71, your out-of-pocket cost would be approximately $164.54. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$822.71
Average Hospital Charge
$896.06
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$896.06
Medicare Allowed$822.71
Medicare Payment$822.71

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $822.71 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$829$931278+0.8%
Pennsylvania$829$84911,100+0.8%
Oklahoma$829$1,0323296+0.7%
New Jersey$828$88641,785+0.6%
Texas$822$885159,949-0.1%
Florida$822$1,01311797-0.1%
Maryland$813$1,270196-1.2%
Arizona$665$1,000179-19.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber