Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody
Medicare pricing data for 1,071 providers across 42 states
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
Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody (HCPCS code 86769) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $41.21, but hospitals typically charge $79.03 — a 1.9x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $41.21, your out-of-pocket cost would be approximately $8.24. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $41.21 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Illinois | $41 | $60 | 29 | 1,755 | +0.2% |
| Iowa | $41 | $50 | 3 | 66 | +0.2% |
| Kansas | $41 | $57 | 8 | 1,045 | +0.2% |
| Kentucky | $41 | $99 | 12 | 126 | +0.2% |
| Louisiana | $41 | $46 | 16 | 175 | +0.2% |
| Maine | $41 | $82 | 2 | 47 | +0.2% |
| Maryland | $41 | $62 | 15 | 1,236 | +0.2% |
| Massachusetts | $41 | $66 | 12 | 2,699 | +0.2% |
| New Mexico | $41 | $75 | 2 | 45 | +0.2% |
| North Dakota | $41 | $121 | 2 | 14 | +0.2% |
| Rhode Island | $41 | $42 | 1 | 45 | +0.2% |
| South Dakota | $41 | $84 | 3 | 19 | +0.2% |
| Utah | $41 | $84 | 5 | 35 | +0.2% |
| Wisconsin | $41 | $86 | 9 | 244 | +0.2% |
| Connecticut | $41 | $86 | 5 | 15 | +0.2% |
| New Jersey | $41 | $77 | 82 | 54,602 | +0.1% |
| Colorado | $41 | $45 | 6 | 391 | +0.1% |
| Nevada | $41 | $56 | 2 | 1,403 | +0.1% |
| Ohio | $41 | $109 | 14 | 3,630 | +0.1% |
| Texas | $41 | $66 | 75 | 13,894 | +0.1% |
| Florida | $41 | $66 | 124 | 29,254 | +0.1% |
| Arizona | $41 | $75 | 29 | 2,975 | +0.1% |
| New York | $41 | $125 | 224 | 39,132 | -0.0% |
| Oklahoma | $41 | $52 | 14 | 820 | -0.0% |
| Alabama | $41 | $45 | 30 | 2,804 | -0.0% |
| North Carolina | $41 | $56 | 45 | 13,641 | -0.1% |
| California | $41 | $60 | 99 | 51,719 | -0.1% |
| Nebraska | $41 | $72 | 4 | 256 | -0.1% |
| Pennsylvania | $41 | $62 | 16 | 2,210 | -0.1% |
| Mississippi | $41 | $99 | 8 | 276 | -0.2% |
| Georgia | $41 | $103 | 23 | 2,757 | -0.2% |
| Washington | $41 | $48 | 13 | 707 | -0.2% |
| Puerto Rico | $41 | $67 | 9 | 44 | -0.3% |
| Minnesota | $41 | $52 | 6 | 438 | -0.6% |
| Missouri | $41 | $249 | 13 | 2,326 | -0.6% |
| Tennessee | $41 | $71 | 52 | 2,426 | -0.7% |
| Virginia | $41 | $48 | 10 | 343 | -0.9% |
| Indiana | $41 | $51 | 3 | 139 | -1.2% |
| South Carolina | $41 | $54 | 6 | 518 | -1.2% |
| Michigan | $41 | $109 | 24 | 500 | -1.5% |
| Hawaii | $40 | $41 | 2 | 112 | -2.9% |
| Oregon | $39 | $63 | 5 | 87 | -5.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber