83993

Stool calprotectin (protein) level

Medicare pricing data for 431 providers across 41 states

🤖AI Overview

This procedure has a 9.8x markup — hospitals charge $187.43 but Medicare allows only $19.21. Uninsured patients may face bills 9.8 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

Stool calprotectin (protein) level (HCPCS code 83993) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.21, but hospitals typically charge $187.43 — a 9.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.21, your out-of-pocket cost would be approximately $3.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.21
Average Hospital Charge
$187.43
Markup Ratio
9.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$187.43
Medicare Allowed$19.21
Medicare Payment$19.21

Hospitals charge 9.8x more than what Medicare allows for this procedure. Medicare actually pays $19.21 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$19$7836,396+0.2%
Illinois$19$217101,300+0.2%
Indiana$19$1561170+0.2%
Kentucky$19$60291+0.2%
Louisiana$19$237319+0.2%
Nevada$19$2542509+0.2%
New Hampshire$19$631531+0.2%
New Mexico$19$4992260+0.2%
North Dakota$19$190939+0.2%
Pennsylvania$19$2967817+0.2%
Rhode Island$19$601231+0.2%
South Carolina$19$187540+0.2%
South Dakota$19$864263+0.2%
Connecticut$19$213256+0.2%
Florida$19$262107,105+0.1%
Kansas$19$25541,654+0.1%
Massachusetts$19$256123,298+0.1%
North Carolina$19$216725,060+0.1%
Virginia$19$1118843+0.1%
New Jersey$19$1167224,716+0.1%
New York$19$277142,124+0.1%
Ohio$19$170132,017+0.1%
Texas$19$262254,688+0.1%
California$19$226368,599+0.1%
Alabama$19$21531,2520.0%
Arizona$19$25344,5050.0%
Arkansas$19$4161,567-0.1%
Oklahoma$19$2085887-0.2%
Oregon$19$1936571-0.2%
Utah$19$448964-0.3%
Tennessee$19$6141,093-0.3%
Maryland$19$129112,525-0.4%
Washington$19$246153,391-0.4%
Colorado$19$2086338-0.4%
Minnesota$19$210441,135-0.4%
Maine$19$1315124-0.5%
Iowa$19$113580-0.6%
Hawaii$19$2132217-0.7%
Wisconsin$19$175121,056-0.9%
Mississippi$19$5142165-1.2%
Michigan$15$818100-20.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber