Gene analysis (fanconi anemia, complementation group c) common variant
Medicare pricing data for 65 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 (fanconi anemia, complementation group c) common variant (HCPCS code 81242) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $35.89, but hospitals typically charge $43.23 — 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 $35.89, your out-of-pocket cost would be approximately $7.18. 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 $35.89 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $36 | $45 | 22 | 14,207 | 0.0% |
| Louisiana | $36 | $53 | 2 | 119 | 0.0% |
| Mississippi | $36 | $110 | 1 | 11 | 0.0% |
| New Jersey | $36 | $42 | 9 | 6,182 | 0.0% |
| Oklahoma | $36 | $42 | 2 | 98 | 0.0% |
| Pennsylvania | $36 | $37 | 2 | 4,159 | 0.0% |
| Texas | $36 | $43 | 23 | 9,076 | 0.0% |
| Arizona | $36 | $50 | 1 | 59 | 0.0% |
| Colorado | $36 | $151 | 2 | 91 | 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