86596

Measurement of voltage-gated calcium channel antibody

Medicare pricing data for 117 providers across 30 states

🤖AI Overview

This procedure has a 22.4x markup — hospitals charge $263.96 but Medicare allows only $11.80. Uninsured patients may face bills 22.4 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

Measurement of voltage-gated calcium channel antibody (HCPCS code 86596) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.80, but hospitals typically charge $263.96 — a 22.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.36

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.80, your out-of-pocket cost would be approximately $2.36. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.80
Average Hospital Charge
$263.96
Markup Ratio
22.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$263.96
Medicare Allowed$11.80
Medicare Payment$11.80

Hospitals charge 22.4x more than what Medicare allows for this procedure. Medicare actually pays $11.80 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$12$3211529+0.1%
Hawaii$12$84235+0.1%
Illinois$12$3142418+0.1%
Indiana$12$72137+0.1%
Kansas$12$3122390+0.1%
Maine$12$361113+0.1%
Maryland$12$3212126+0.1%
Massachusetts$12$3543466+0.1%
Minnesota$12$20511475+0.1%
Nevada$12$3271277+0.1%
New Hampshire$12$39113+0.1%
New Jersey$12$29361,376+0.1%
New York$12$441268+0.1%
North Carolina$12$17151,667+0.1%
Ohio$12$166586+0.1%
Oklahoma$12$3212106+0.1%
Pennsylvania$12$2925139+0.1%
South Dakota$12$93211+0.1%
Tennessee$12$247217+0.1%
Texas$12$24471,374+0.1%
Utah$12$124233+0.1%
Washington$12$2874106+0.1%
Alabama$12$151250+0.1%
Arizona$12$2363147+0.1%
Colorado$12$266350+0.1%
Florida$12$30461,2050.0%
California$12$300151,1140.0%
Wisconsin$12$2173147-0.4%
Iowa$12$171291-0.7%
Virginia$12$973129-1.2%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber