86021

Antibody identification test for white blood cell antibodies

Medicare pricing data for 204 providers across 25 states

🤖AI Overview

This procedure has a 19.1x markup — hospitals charge $281.44 but Medicare allows only $14.73. Uninsured patients may face bills 19.1 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

Antibody identification test for white blood cell antibodies (HCPCS code 86021) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.73, but hospitals typically charge $281.44 — a 19.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.73, your out-of-pocket cost would be approximately $2.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.73
Average Hospital Charge
$281.44
Markup Ratio
19.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$281.44
Medicare Allowed$14.73
Medicare Payment$14.73

Hospitals charge 19.1x more than what Medicare allows for this procedure. Medicare actually pays $14.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$15$273207,514+0.1%
Georgia$15$30432,407+0.1%
Hawaii$15$162236+0.1%
Illinois$15$30881,505+0.1%
Indiana$15$84374+0.1%
Kansas$15$30141,296+0.1%
Maine$15$31127+0.1%
Maryland$15$2666695+0.1%
Massachusetts$15$31631,534+0.1%
Nevada$15$3092702+0.1%
New Jersey$15$304107,890+0.1%
North Carolina$15$2457562+0.1%
Oklahoma$15$2846510+0.1%
Pennsylvania$15$3404754+0.1%
South Carolina$15$74262+0.1%
Utah$15$142320+0.1%
Virginia$15$2986132+0.1%
Washington$15$3056437+0.1%
Colorado$15$2853217+0.1%
Texas$15$285163,390+0.1%
California$15$288286,842+0.1%
Arizona$15$29832,830-0.2%
New York$15$164193,010-0.7%
Ohio$15$1706197-0.7%
Alabama$13$33517-10.9%

⚠️ 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