Gene analysis (bloom syndrome, recq helicase-like)
Medicare pricing data for 69 providers across 9 states
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 (bloom syndrome, recq helicase-like) (HCPCS code 81209) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $38.51, but hospitals typically charge $43.92 — a 1.1x 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 $38.51, your out-of-pocket cost would be approximately $7.70. 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 1.1x more than what Medicare allows for this procedure. Medicare actually pays $38.51 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $39 | $58 | 2 | 119 | +0.0% |
| Mississippi | $39 | $118 | 1 | 11 | +0.0% |
| Oklahoma | $39 | $43 | 2 | 99 | +0.0% |
| Pennsylvania | $39 | $39 | 2 | 4,151 | +0.0% |
| Arizona | $39 | $50 | 1 | 60 | +0.0% |
| Colorado | $39 | $161 | 2 | 87 | +0.0% |
| Florida | $39 | $43 | 24 | 16,728 | 0.0% |
| New Jersey | $39 | $45 | 8 | 6,287 | 0.0% |
| Texas | $39 | $45 | 24 | 8,721 | -0.0% |
⚠️ 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