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Platelet function test

Medicare pricing data for 95 providers across 24 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $126.67 but Medicare allows only $17.56. Uninsured patients may face bills 7.2 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Platelet function test (HCPCS code 85597) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.56, but hospitals typically charge $126.67 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.56, your out-of-pocket cost would be approximately $3.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.56
Average Hospital Charge
$126.67
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$126.67
Medicare Allowed$17.56
Medicare Payment$17.56

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $17.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$18$1334999+0.3%
Georgia$18$1311381+0.3%
Illinois$18$1312158+0.3%
Kansas$18$1332150+0.3%
Maryland$18$1224177+0.3%
Massachusetts$18$1322166+0.3%
Minnesota$18$130824+0.3%
Nevada$18$1321121+0.3%
North Carolina$18$1337732+0.3%
Oklahoma$18$128162+0.3%
Pennsylvania$18$132391+0.3%
Utah$18$36112+0.3%
Virginia$18$66339+0.3%
Washington$18$134371+0.3%
Wisconsin$18$76218+0.3%
Alabama$18$1273107+0.3%
Arizona$18$1381184+0.3%
California$18$13281,096+0.3%
Colorado$18$1344441+0.3%
New Jersey$18$13043,100+0.2%
New York$18$932247+0.2%
Ohio$17$1286113-0.5%
Texas$17$1017843-2.3%
Hawaii$17$25125-2.6%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber