Onc Ovrn Bchm Asy 7 Prtn Alg
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Genetic/Molecular Test procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| Texas | $877.69 | $1,495.00 |
What the Data Says About Onc Ovrn Bchm Asy 7 Prtn Alg
Across 1 states with reporting providers, CPT code 0375U (Onc Ovrn Bchm Asy 7 Prtn Alg) shows a national average Medicare payment of $877.69 against an average billed charge of $1,495.00. That gap — a 1.7x markup, or 70% above the Medicare allowed amount — reflects chargemaster pricing, not what most insured patients actually pay. Medicare's negotiated rate is the statutory benchmark; commercial insurers typically settle between the two figures based on network contracts.
Genetic/Molecular Test procedures like this one saw 299 services billed to Medicare in 2023 by 1 distinct providers, serving 296 unique beneficiaries. Regional variation is limited in the underlying CMS file. Geographic Practice Cost Indices (GPCIs) explain much of that spread — local malpractice premiums, practice expense, and physician work adjustments all shift the allowed amount even when the procedure is identical.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Genetic/Molecular Test category (2.24x), the estimated commercial insurance price lands near $1,966.03, with self-pay cash discounts commonly bringing the figure closer to $1,069.39. Uninsured patients facing the full billed charge have the strongest leverage to negotiate — the Hospital Price Transparency Rule (effective January 2021) requires providers to publish standard charges, cash rates, and payer-specific negotiated prices. This data is for educational reference; confirm coverage and out-of-pocket exposure with your insurer before any procedure.
Frequently Asked Questions
How much does Onc Ovrn Bchm Asy 7 Prtn Alg cost?
The national average Medicare payment for Onc Ovrn Bchm Asy 7 Prtn Alg (CPT 0375U) is $877.69, while providers typically bill $1,495.00. Prices vary significantly by state, ranging from $877.69 to $877.69.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Onc Ovrn Bchm Asy 7 Prtn Alg cost with insurance?
With commercial insurance, Onc Ovrn Bchm Asy 7 Prtn Alg costs an estimated $1,966.03 on average (range: $1,376.22 – $2,752.45). Without insurance, the estimated cash price is $1,069.39. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.
How many providers perform Onc Ovrn Bchm Asy 7 Prtn Alg?
Nationally, 1 providers billed Medicare for Onc Ovrn Bchm Asy 7 Prtn Alg in 2023, performing 299 total services for 296 beneficiaries across 1 states and territories.
What is the billed-to-Medicare markup for Onc Ovrn Bchm Asy 7 Prtn Alg?
Providers bill 1.7x what Medicare pays for Onc Ovrn Bchm Asy 7 Prtn Alg — a 70% markup. This gap between billed charges and actual payment is common across healthcare. Uninsured patients may face charges closer to the billed amount, while insured patients pay negotiated rates between the Medicare and billed figures.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.