83520

Measurement of substance using immunoassay technique

Medicare pricing data for 796 providers across 46 states

🤖AI Overview

This procedure has a 6.8x markup — hospitals charge $114.48 but Medicare allows only $16.83. Uninsured patients may face bills 6.8 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

Measurement of substance using immunoassay technique (HCPCS code 83520) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.83, but hospitals typically charge $114.48 — a 6.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $16.83, your out-of-pocket cost would be approximately $3.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$16.83
Average Hospital Charge
$114.48
Markup Ratio
6.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$114.48
Medicare Allowed$16.83
Medicare Payment$16.83

Hospitals charge 6.8x more than what Medicare allows for this procedure. Medicare actually pays $16.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$17$137168,067+0.6%
Delaware$17$1673155+0.5%
Kentucky$17$66329+0.5%
Maine$17$1862117+0.5%
New Hampshire$17$144426+0.5%
New Mexico$17$1567125+0.5%
North Dakota$17$4484,284+0.5%
Ohio$17$841419,285+0.5%
Rhode Island$17$421374+0.5%
Tennessee$17$1738795+0.5%
Wyoming$17$702230+0.5%
Connecticut$17$191331+0.5%
Florida$17$1313246,036+0.5%
New Jersey$17$1092544,941+0.5%
Oklahoma$17$14571,799+0.5%
Pennsylvania$17$116173,439+0.5%
Texas$17$764743,448+0.5%
Colorado$17$14282,273+0.5%
Kansas$17$156115,767+0.4%
Nevada$17$15333,825+0.4%
North Carolina$17$1452031,462+0.4%
Georgia$17$1221520,902+0.4%
Maryland$17$1544710,296+0.4%
Minnesota$17$144384,274+0.4%
Alabama$17$152142,338+0.4%
Arkansas$17$44214,565+0.4%
Oregon$17$137232,855+0.2%
Indiana$17$9413642+0.2%
Iowa$17$84121,153+0.2%
Massachusetts$17$941826,592+0.2%
Virginia$17$1584713,964+0.1%
Washington$17$142143,187+0.1%
Arizona$17$11588,770+0.1%
South Carolina$17$997136-0.1%
Utah$17$6716590-0.1%
Puerto Rico$17$2034167-0.1%
Hawaii$17$1432544-0.2%
South Dakota$17$120599-0.4%
Idaho$17$9213419-0.6%
Missouri$17$78225,994-0.6%
Wisconsin$17$1539694-1.0%
California$17$1028253,715-1.1%
Michigan$17$1279139-1.7%
New York$16$1586614,683-3.7%
Louisiana$15$130659-11.4%
Mississippi$14$110966-14.3%

⚠️ 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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