89051

Body fluid cell count with cell identification

Medicare pricing data for 549 providers across 42 states

🤖AI Overview

This procedure has a 8.7x markup — hospitals charge $47.71 but Medicare allows only $5.48. Uninsured patients may face bills 8.7 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

Body fluid cell count with cell identification (HCPCS code 89051) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.48, but hospitals typically charge $47.71 — a 8.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.48, your out-of-pocket cost would be approximately $1.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.48
Average Hospital Charge
$47.71
Markup Ratio
8.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$47.71
Medicare Allowed$5.48
Medicare Payment$5.48

Hospitals charge 8.7x more than what Medicare allows for this procedure. Medicare actually pays $5.48 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Tennessee$6$548256+0.7%
District of Columbia$5$20431+0.2%
Georgia$5$537322+0.2%
Hawaii$5$192152+0.2%
Indiana$5$54361+0.2%
Kentucky$5$21377+0.2%
Louisiana$5$488120+0.2%
Maine$5$309101+0.2%
Maryland$5$20309,419+0.2%
Missouri$5$54557+0.2%
Nebraska$5$53257+0.2%
Nevada$5$532243+0.2%
New Mexico$5$170160+0.2%
New York$5$35341,303+0.2%
North Dakota$5$54672+0.2%
Oregon$5$324135+0.2%
South Carolina$5$16314+0.2%
California$5$56234,252+0.2%
Colorado$5$696388+0.2%
Florida$5$55156,1570.0%
Massachusetts$5$54419380.0%
Minnesota$5$74458580.0%
New Jersey$5$55694,9110.0%
North Carolina$5$68112,2290.0%
Texas$5$50313,3150.0%
Arizona$5$5134800.0%
Illinois$5$808697-0.2%
Iowa$5$2818221-0.2%
Oklahoma$5$565216-0.2%
Pennsylvania$5$9511847-0.2%
Utah$5$483174-0.2%
Alabama$5$684297-0.2%
Kansas$5$6317410-0.4%
Ohio$5$6215570-0.4%
Washington$5$5832722-0.4%
Michigan$5$24987-0.7%
South Dakota$5$423222-0.7%
Virginia$5$236292-0.7%
Mississippi$5$4422,663-1.3%
Wisconsin$5$5916388-1.8%
Arkansas$5$20326-2.6%
Idaho$5$38146-6.4%

⚠️ 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