Gene analysis (coagulation factor ix) full sequence analysis
Medicare pricing data for 67 providers across 8 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 (coagulation factor ix) full sequence analysis (HCPCS code 81238) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $587.04, but hospitals typically charge $696.84 — a 1.2x 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 $587.04, your out-of-pocket cost would be approximately $117.41. 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 1.2x more than what Medicare allows for this procedure. Medicare actually pays $587.04 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Louisiana | $588 | $796 | 2 | 174 | +0.2% |
| New Jersey | $588 | $699 | 5 | 5,554 | +0.2% |
| Oklahoma | $588 | $800 | 2 | 206 | +0.2% |
| Pennsylvania | $588 | $601 | 2 | 2,310 | +0.2% |
| Colorado | $588 | $2,346 | 2 | 98 | +0.2% |
| Florida | $588 | $717 | 24 | 16,492 | +0.1% |
| Texas | $586 | $661 | 27 | 9,159 | -0.2% |
| Arizona | $508 | $700 | 1 | 102 | -13.5% |
⚠️ 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