85651

Red blood cell sedimentation rate, to detect inflammation, non-automated

Medicare pricing data for 9,379 providers across 51 states

🤖AI Overview

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

Red blood cell sedimentation rate, to detect inflammation, non-automated (HCPCS code 85651) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.17, but hospitals typically charge $19.63 — a 4.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.17, your out-of-pocket cost would be approximately $0.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.17
Average Hospital Charge
$19.63
Markup Ratio
4.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$19.63
Medicare Allowed$4.17
Medicare Payment$4.17

Hospitals charge 4.7x more than what Medicare allows for this procedure. Medicare actually pays $4.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$4$92280+0.2%
Florida$4$1322233,731+0.2%
Nevada$4$1411385+0.2%
New Jersey$4$2610969,060+0.2%
North Dakota$4$2329494+0.2%
Rhode Island$4$14633+0.2%
Arizona$4$14581,493+0.2%
Hawaii$4$1334,3830.0%
Illinois$4$2212218,9000.0%
Kentucky$4$191111,9670.0%
Massachusetts$4$147309,8330.0%
Minnesota$4$161631,3100.0%
Montana$4$15285530.0%
Nebraska$4$152174,0030.0%
New Hampshire$4$13981,7710.0%
New York$4$2695560,7280.0%
North Carolina$4$224679,6640.0%
Ohio$4$15383,6300.0%
West Virginia$4$17459300.0%
California$4$18431134,6690.0%
Colorado$4$13796420.0%
Connecticut$4$16231,2740.0%
Georgia$4$252717,735-0.2%
Idaho$4$2144227-0.2%
Iowa$4$163595,584-0.2%
Kansas$4$281865,782-0.2%
Louisiana$4$181226,994-0.2%
Maryland$4$172749,196-0.2%
Mississippi$4$232168,072-0.2%
Pennsylvania$4$288012,231-0.2%
South Dakota$4$1887685-0.2%
Virginia$4$2131412,106-0.2%
Wyoming$4$3339278-0.2%
Puerto Rico$4$44526,497-0.2%
Arkansas$4$192553,172-0.2%
Indiana$4$17948,771-0.5%
Missouri$4$181739,223-0.5%
New Mexico$4$1628423-0.5%
Oklahoma$4$171135,014-0.5%
South Carolina$4$231474,428-0.5%
Utah$4$121431,672-0.5%
Wisconsin$4$343084,389-0.5%
Alaska$4$33821,380-0.5%
Maine$4$12441,027-0.7%
Oregon$4$131007,529-0.7%
Texas$4$1443224,747-0.7%
Alabama$4$1434914,739-0.7%
Michigan$4$141678,267-1.0%
Washington$4$112893,683-1.4%
Tennessee$4$132064,199-1.9%
Vermont$4$2039156-2.2%

⚠️ 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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