84238

Chemical receptor analysis

Medicare pricing data for 210 providers across 31 states

🤖AI Overview

This procedure has a 5.1x markup — hospitals charge $181.57 but Medicare allows only $35.29. Uninsured patients may face bills 5.1 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

Chemical receptor analysis (HCPCS code 84238) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $35.29, but hospitals typically charge $181.57 — a 5.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $35.29, your out-of-pocket cost would be approximately $7.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$35.29
Average Hospital Charge
$181.57
Markup Ratio
5.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$181.57
Medicare Allowed$35.29
Medicare Payment$35.29

Hospitals charge 5.1x more than what Medicare allows for this procedure. Medicare actually pays $35.29 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$36$2601603+1.6%
Hawaii$36$190126+1.6%
Indiana$36$199316+1.6%
Iowa$36$61219+1.6%
Maryland$36$2572314+1.6%
Massachusetts$36$2622282+1.6%
New York$36$20551,117+1.6%
Ohio$36$1879278+1.6%
Oregon$36$83221+1.6%
Rhode Island$36$75119+1.6%
Utah$36$742222+1.6%
Washington$36$144213+1.6%
Alabama$36$1354229+1.6%
Colorado$36$2514203+1.6%
Illinois$36$14151,273+1.5%
Tennessee$36$9531,962+1.5%
Nebraska$36$1215471+1.5%
Kansas$36$2684788+1.4%
New Jersey$36$18753,103+1.4%
Florida$36$200141,809+1.4%
Nevada$36$2612494+1.4%
North Carolina$36$18462,545+1.3%
Minnesota$36$22952962+1.2%
Texas$36$213121,290+1.0%
Michigan$36$1025681+1.0%
Arizona$36$2433147+1.0%
Wisconsin$36$3087331+0.7%
Pennsylvania$35$15761,091+0.6%
Virginia$34$1485105-3.5%
Arkansas$31$92116-11.9%
California$30$152161,868-14.4%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber