Protein c antigen (clotting inhibitor) measurement
Medicare pricing data for 248 providers across 33 states
This procedure has a 13.5x markup — hospitals charge $182.63 but Medicare allows only $13.54. Uninsured patients may face bills 13.5 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
Protein c antigen (clotting inhibitor) measurement (HCPCS code 85303) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.54, but hospitals typically charge $182.63 — a 13.5x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $13.54, your out-of-pocket cost would be approximately $2.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 13.5x more than what Medicare allows for this procedure. Medicare actually pays $13.54 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $14 | $223 | 9 | 1,319 | +0.1% |
| Georgia | $14 | $226 | 1 | 638 | +0.1% |
| Indiana | $14 | $101 | 3 | 23 | +0.1% |
| Iowa | $14 | $86 | 2 | 37 | +0.1% |
| Massachusetts | $14 | $218 | 4 | 297 | +0.1% |
| Michigan | $14 | $59 | 4 | 31 | +0.1% |
| Minnesota | $14 | $206 | 29 | 345 | +0.1% |
| Nevada | $14 | $226 | 2 | 188 | +0.1% |
| New Mexico | $14 | $148 | 2 | 55 | +0.1% |
| New York | $14 | $256 | 15 | 522 | +0.1% |
| Oklahoma | $14 | $200 | 3 | 112 | +0.1% |
| Oregon | $14 | $87 | 4 | 44 | +0.1% |
| Pennsylvania | $14 | $212 | 7 | 186 | +0.1% |
| South Dakota | $14 | $155 | 3 | 20 | +0.1% |
| Tennessee | $14 | $81 | 4 | 154 | +0.1% |
| Utah | $14 | $53 | 3 | 39 | +0.1% |
| Puerto Rico | $14 | $14 | 9 | 28 | +0.1% |
| Alabama | $14 | $148 | 3 | 113 | +0.1% |
| North Carolina | $14 | $177 | 8 | 2,349 | +0.1% |
| Arizona | $14 | $213 | 4 | 1,738 | +0.1% |
| California | $14 | $177 | 20 | 1,468 | +0.1% |
| Colorado | $14 | $158 | 5 | 388 | 0.0% |
| Kansas | $14 | $206 | 5 | 270 | -0.1% |
| New Jersey | $14 | $192 | 25 | 2,923 | -0.1% |
| Texas | $14 | $109 | 13 | 1,859 | -0.1% |
| Maryland | $14 | $202 | 4 | 275 | -0.1% |
| Wisconsin | $13 | $165 | 7 | 149 | -0.5% |
| Illinois | $13 | $221 | 5 | 212 | -0.8% |
| Ohio | $13 | $123 | 10 | 199 | -0.8% |
| Washington | $13 | $153 | 5 | 111 | -1.6% |
| Virginia | $13 | $53 | 5 | 93 | -1.6% |
| Hawaii | $13 | $64 | 2 | 60 | -1.9% |
| North Dakota | $13 | $97 | 5 | 17 | -5.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber