84378

Carbohydrate analysis, single quantitative

Medicare pricing data for 80 providers across 10 states

🤖AI Overview

This procedure has a 9.3x markup — hospitals charge $104.66 but Medicare allows only $11.30. Uninsured patients may face bills 9.3 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

Carbohydrate analysis, single quantitative (HCPCS code 84378) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.30, but hospitals typically charge $104.66 — a 9.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.30, your out-of-pocket cost would be approximately $2.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.30
Average Hospital Charge
$104.66
Markup Ratio
9.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$104.66
Medicare Allowed$11.30
Medicare Payment$11.30

Hospitals charge 9.3x more than what Medicare allows for this procedure. Medicare actually pays $11.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Illinois$11$1101240.0%
Kansas$11$942440.0%
Maryland$11$8431460.0%
New Jersey$11$74114,5900.0%
New York$11$1371310,6120.0%
Ohio$11$9932200.0%
Pennsylvania$11$1355310.0%
Texas$11$11154050.0%
Colorado$11$842760.0%
Florida$11$55213,011-0.3%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber