81249

Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis

Medicare pricing data for 77 providers across 9 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 (glucose-6-phosphate dehydrogenase) full sequence analysis (HCPCS code 81249) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $587.66, but hospitals typically charge $661.47 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$117.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $587.66, your out-of-pocket cost would be approximately $117.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$587.66
Average Hospital Charge
$661.47
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$661.47
Medicare Allowed$587.66
Medicare Payment$587.66

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $587.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Louisiana$588$718237+0.1%
Mississippi$588$1,800130+0.1%
Pennsylvania$588$60122,396+0.1%
Texas$588$6313312,519+0.1%
Arizona$588$700123+0.1%
Colorado$588$2,469287+0.1%
Florida$588$6622514,992+0.0%
Oklahoma$587$8783210-0.1%
New Jersey$586$70975,915-0.3%

⚠️ 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