82105

Alpha-fetoprotein (afp) level, serum

Medicare pricing data for 2,039 providers across 46 states

🤖AI Overview

This procedure has a 6.6x markup — hospitals charge $108.07 but Medicare allows only $16.40. Uninsured patients may face bills 6.6 times higher than what insurance negotiates. 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

Alpha-fetoprotein (afp) level, serum (HCPCS code 82105) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.40, but hospitals typically charge $108.07 — a 6.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $16.40, your out-of-pocket cost would be approximately $3.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$16.40
Average Hospital Charge
$108.07
Markup Ratio
6.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$108.07
Medicare Allowed$16.40
Medicare Payment$16.40

Hospitals charge 6.6x more than what Medicare allows for this procedure. Medicare actually pays $16.40 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$16$19120397+0.2%
Georgia$16$15252,831+0.2%
Louisiana$16$836168+0.2%
Missouri$16$1591569+0.2%
Nebraska$16$528112+0.2%
New Hampshire$16$611149+0.2%
New Mexico$16$7713408+0.2%
Rhode Island$16$421217+0.2%
Utah$16$4317185+0.2%
Alaska$16$1701529+0.2%
Arkansas$16$5224242+0.2%
Connecticut$16$112443+0.2%
Massachusetts$16$1311132,923+0.1%
New York$16$1152496,147+0.1%
Oklahoma$16$7392,059+0.1%
Pennsylvania$16$117131,783+0.1%
Colorado$16$108101,282+0.1%
Florida$16$1263312,588+0.1%
Kansas$16$128263,083+0.1%
New Jersey$16$1238314,130+0.1%
Virginia$16$63661,235+0.1%
California$16$10515334,506+0.1%
Michigan$16$51283170.0%
North Carolina$16$981910,7760.0%
Oregon$16$63628630.0%
Texas$16$11416515,6060.0%
Arizona$16$10865,0170.0%
Illinois$16$132942,015-0.1%
Maryland$16$104111,860-0.1%
Nevada$16$134361,184-0.1%
Ohio$16$86294,438-0.1%
Indiana$16$4212194-0.2%
South Carolina$16$5518237-0.2%
Hawaii$16$4821,456-0.3%
Kentucky$16$607319-0.3%
Washington$16$1091133,312-0.4%
Maine$16$403132-0.4%
Iowa$16$7536615-0.5%
North Dakota$16$818149-0.5%
Tennessee$16$58911,554-0.5%
Minnesota$16$1221701,437-0.5%
Alabama$16$91434,110-0.9%
South Dakota$16$9615310-1.0%
Mississippi$16$7141792-1.2%
Wisconsin$16$120161,088-1.3%
Idaho$16$77947-1.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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