88264

Chromosome analysis for genetic defects, analyze 20-25 cells

Medicare pricing data for 166 providers across 29 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

Chromosome analysis for genetic defects, analyze 20-25 cells (HCPCS code 88264) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $141.32, but hospitals typically charge $433.02 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $141.32, your out-of-pocket cost would be approximately $28.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$141.32
Average Hospital Charge
$433.02
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$433.02
Medicare Allowed$141.32
Medicare Payment$141.32

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $141.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$142$423314+0.3%
Illinois$142$391488+0.3%
Indiana$142$231240+0.3%
Maryland$142$587260+0.3%
Massachusetts$142$591262+0.3%
Michigan$142$308325+0.3%
Nevada$142$6361116+0.3%
New Mexico$142$842119+0.3%
North Carolina$142$562445+0.3%
Oklahoma$142$4712138+0.3%
Utah$142$431932+0.3%
Virginia$142$4104172+0.3%
Wisconsin$142$930943+0.3%
Puerto Rico$142$145221+0.3%
Arizona$142$57641,537+0.3%
New York$142$6385695+0.2%
Pennsylvania$142$6715474+0.2%
Texas$142$331143,051+0.2%
Tennessee$141$529162,334+0.1%
Florida$141$382174,144+0.0%
New Jersey$141$71331,100+0.0%
California$141$237102,912+0.0%
Minnesota$141$2208717+0.0%
Georgia$141$3673474-0.0%
Washington$141$5096387-0.3%
Connecticut$141$57841,180-0.4%
Kansas$141$627487-0.4%
Missouri$134$605112-5.0%
Ohio$122$304466-13.9%

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

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