Protein s (clotting inhibitor) measurement
Medicare pricing data for 260 providers across 33 states
This procedure has a 13.8x markup — hospitals charge $206.16 but Medicare allows only $14.99. Uninsured patients may face bills 13.8 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
Protein s (clotting inhibitor) measurement (HCPCS code 85306) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.99, but hospitals typically charge $206.16 — a 13.8x 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 $14.99, your out-of-pocket cost would be approximately $3.00. 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 13.8x more than what Medicare allows for this procedure. Medicare actually pays $14.99 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Florida | $15 | $254 | 8 | 1,376 | +0.1% |
| Georgia | $15 | $253 | 1 | 749 | +0.1% |
| Indiana | $15 | $97 | 3 | 29 | +0.1% |
| Iowa | $15 | $82 | 2 | 40 | +0.1% |
| Massachusetts | $15 | $242 | 4 | 289 | +0.1% |
| Michigan | $15 | $93 | 4 | 33 | +0.1% |
| Minnesota | $15 | $209 | 28 | 341 | +0.1% |
| Nevada | $15 | $243 | 2 | 242 | +0.1% |
| New Mexico | $15 | $156 | 2 | 56 | +0.1% |
| Oklahoma | $15 | $220 | 3 | 125 | +0.1% |
| Pennsylvania | $15 | $238 | 6 | 206 | +0.1% |
| South Dakota | $15 | $130 | 3 | 21 | +0.1% |
| Tennessee | $15 | $124 | 7 | 166 | +0.1% |
| Utah | $15 | $40 | 3 | 103 | +0.1% |
| Puerto Rico | $15 | $16 | 9 | 26 | +0.1% |
| Alabama | $15 | $183 | 4 | 200 | +0.1% |
| North Carolina | $15 | $217 | 9 | 4,000 | +0.1% |
| New Jersey | $15 | $204 | 25 | 4,420 | 0.0% |
| New York | $15 | $196 | 14 | 621 | 0.0% |
| Arizona | $15 | $250 | 6 | 2,475 | 0.0% |
| California | $15 | $212 | 21 | 1,720 | 0.0% |
| Colorado | $15 | $178 | 4 | 418 | 0.0% |
| Maryland | $15 | $223 | 4 | 310 | -0.1% |
| Texas | $15 | $129 | 16 | 2,043 | -0.1% |
| Wisconsin | $15 | $196 | 6 | 158 | -0.5% |
| Illinois | $15 | $191 | 8 | 301 | -0.5% |
| Kansas | $15 | $229 | 5 | 338 | -0.6% |
| Ohio | $15 | $152 | 12 | 259 | -0.6% |
| Oregon | $15 | $79 | 4 | 38 | -0.8% |
| Virginia | $15 | $57 | 5 | 121 | -1.2% |
| Washington | $15 | $183 | 6 | 119 | -1.5% |
| Hawaii | $15 | $67 | 2 | 62 | -1.9% |
| North Dakota | $14 | $92 | 5 | 18 | -5.4% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber