Measurement of proteins associated with prostate cancer
Medicare pricing data for 16 providers across 3 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
Measurement of proteins associated with prostate cancer (HCPCS code 81539) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $743.45, but hospitals typically charge $829.40 — 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 $743.45, your out-of-pocket cost would be approximately $148.69. 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 $743.45 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Ohio | $745 | $1,155 | 1 | 16 | +0.2% |
| New Jersey | $743 | $816 | 1 | 13,498 | +0.0% |
| New York | $741 | $1,758 | 3 | 177 | -0.4% |
⚠️ 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