New Jersey · 81257

Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant in New Jersey

New Jersey Medicare Avg
$99.87
0% below national avg
National Medicare Avg
$99.93
All states combined
Billed Charge (NJ)
$593.80
What providers submit
Est. Commercial (NJ)
$254.68
National avg: $223.84
Est. Cash / Self-Pay (NJ)
$238.20
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

635
Services in NJ
4
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in New Jersey

Provider Medicare Services
Quest Diagnostics Incorporated $100.11 401
Bioreference Health, Llc $99.80 219
Laboratory Corporation Of America... $93.85 13

New Jersey Pricing in Context

In New Jersey, CPT code 81257 (Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant) carries an average Medicare payment of $99.87 — 0% below the national benchmark of $99.93. 4 providers across the state submitted claims for this procedure in 2023, performing 635 total services. Individual payments in NJ ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in New Jersey is $593.80, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because New Jersey sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Genetic/Molecular Test procedures, the estimated commercial insurance price in New Jersey lands near $254.68, with self-pay cash prices typically around $238.20. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant cost in New Jersey?

The average Medicare payment for Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant in New Jersey is $99.87, which is 0% below the national average of $99.93. Providers in NJ typically bill $593.80 for this procedure.

What does Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant cost with insurance in New Jersey?

With commercial insurance in New Jersey, Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant costs an estimated $254.68. Without insurance, the estimated cash price is $238.20. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant in New Jersey?

4 providers in New Jersey billed Medicare for Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant in 2023, performing 635 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant cheaper in New Jersey than the national average?

Yes — Gene Analysis (alpha Globin 1 And Alpha Globin 2) For Common Deletions Or Variant costs 0% below the national average in New Jersey. The state average Medicare payment is $99.87 compared to $99.93 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial