86753

Analysis for antibody to protozoa (parasite)

Medicare pricing data for 150 providers across 24 states

🤖AI Overview

This procedure has a 7.9x markup — hospitals charge $95.24 but Medicare allows only $12.12. Uninsured patients may face bills 7.9 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

Analysis for antibody to protozoa (parasite) (HCPCS code 86753) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.12, but hospitals typically charge $95.24 — a 7.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.42

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.12, your out-of-pocket cost would be approximately $2.42. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.12
Average Hospital Charge
$95.24
Markup Ratio
7.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$95.24
Medicare Allowed$12.12
Medicare Payment$12.12

Hospitals charge 7.9x more than what Medicare allows for this procedure. Medicare actually pays $12.12 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Georgia$12$1031543+0.2%
Illinois$12$1211599+0.2%
Kansas$12$10231,621+0.2%
Maryland$12$963441+0.2%
Massachusetts$12$9347,288+0.2%
Oklahoma$12$103399+0.2%
Rhode Island$12$251243+0.2%
Tennessee$12$114347+0.2%
Utah$12$31319+0.2%
Virginia$12$674148+0.2%
Washington$12$114332+0.2%
Wisconsin$12$78880+0.2%
Arizona$12$112379+0.2%
California$12$67188,060+0.2%
Connecticut$12$89225+0.2%
New York$12$9393,478+0.1%
Minnesota$12$10665310.0%
North Carolina$12$14053,9570.0%
Pennsylvania$12$8856220.0%
Texas$12$116104240.0%
Florida$12$904678-0.1%
New Jersey$12$981521,837-0.2%
Alabama$12$135388-0.5%
Ohio$12$1148208-0.7%

⚠️ 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