Laboratory · 82397

Analysis Using Chemiluminescent Technique (light And Chemical )reaction

What Medicare pays for 82397, what providers bill, and how the price varies across 29 states, drawn from CMS 2023 claims data.

82397 · the short answer

For analysis using chemiluminescent technique (light and chemical )reaction, Medicare pays about $13.83 while providers bill $141.81 on average, a 10.3× markup, one of the steepest markups in the catalog. State-level Medicare rates range 2% from lowest to highest.

Medicare pays
$13.83
Providers bill
$141.81
Markup
10.3×
Markup percentile
91th

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$13.83
What Medicare actually pays
Billed Charge (avg)
$141.81
What providers submit
Markup
10.3x
925% above Medicare rate
22.1K
Total Services
17.2K
Beneficiaries
198
Providers
29
States with Data

Price Range Across States

Lowest State Avg
$13.52
Maryland
Highest State Avg
$13.86
Arizona

What You Might Pay

Est. Commercial Insurance
$30.98
Range: $21.68 – $43.37
Est. Cash / Self-Pay
$49.37
Typical self-pay discount

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: Laboratory 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.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

10 Among the most affordable more affordable than 91% of 8,901 procedures

1–2: 466 procedures (5%). Below this entry. 2–3: 681 procedures (8%). Below this entry. 3–4: 845 procedures (9%). Below this entry. 4–5: 1,308 procedures (15%). Below this entry. 5–6: 1,725 procedures (19%). Below this entry. 6–7: 1,217 procedures (14%). Below this entry. 7–8: 801 procedures (9%). Below this entry. 8–9: 541 procedures (6%). Below this entry. 9–10: 351 procedures (4%). Below this entry. 10–11: 246 procedures (3%). This entry sits in this band. 11–12: 151 procedures (2%). Above this entry. 12–13: 175 procedures (2%). Above this entry. 13–14: 140 procedures (2%). Above this entry. 14–15: 40 procedures (0%). Above this entry. 15–16: 39 procedures (0%). Above this entry. 16–17: 26 procedures (0%). Above this entry. 17–18: 25 procedures (0%). Above this entry. 18–19: 21 procedures (0%). Above this entry. 19–20: 12 procedures (0%). Above this entry. 20–21: 16 procedures (0%). Above this entry. 21–22: 13 procedures (0%). Above this entry. 22–23: 8 procedures (0%). Above this entry. 23–24: 9 procedures (0%). Above this entry. 24–25: 4 procedures (0%). Above this entry. 25–26: 3 procedures (0%). Above this entry. 26–27: 3 procedures (0%). Above this entry. 27–28: 4 procedures (0%). Above this entry. 28–29: 3 procedures (0%). Above this entry. 29–30: 2 procedures (0%). Above this entry. 30–31: 26 procedures (0%). Above this entry. this procedure 1 31 × markup, bucketed by value

Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

Prices by State

State Medicare Payment Billed Charge
Arizona $13.86 $135.81
Colorado $13.84 $163.97
Florida $13.84 $91.33
Illinois $13.84 $67.03
Kansas $13.84 $174.79
Maine $13.84 $231.88
Michigan $13.84 $143.69
New Hampshire $13.84 $96.83
North Carolina $13.84 $169.20
Pennsylvania $13.84 $414.44
Tennessee $13.84 $221.29
Utah $13.84 $60.92
Virginia $13.84 $70.18
Wisconsin $13.84 $150.39
New Mexico $13.84 $124.44
Oklahoma $13.84 $440.44
South Dakota $13.84 $86.63
New York $13.84 $193.76
Texas $13.84 $171.34
New Jersey $13.84 $146.82
California $13.83 $126.03
Ohio $13.82 $155.32
Alabama $13.82 $157.59
Minnesota $13.79 $252.96
Oregon $13.71 $141.48
Washington $13.69 $171.39
Iowa $13.67 $104.24
Hawaii $13.64 $150.39
Maryland $13.52 $52.96

What the Data Says About Analysis Using Chemiluminescent Technique (light And Chemical )reaction

Across 29 states with reporting providers, CPT code 82397 (Analysis Using Chemiluminescent Technique (light And Chemical )reaction) shows a national average Medicare payment of $13.83 against an average billed charge of $141.81. That gap, a 10.3x markup, or 925% above the Medicare allowed amount, sits among the widest billed-to-paid spreads we track, the kind of chargemaster pricing almost no payer, insured or cash, actually honors in full.

Laboratory procedures like this one saw 22.1K services billed to Medicare in 2023 by 198 distinct providers, serving 17.2K unique beneficiaries. State-level variation is significant: Maryland reports the lowest average payment at $13.52, while Arizona reports the highest at $13.86. At just 2%, this procedure prices remarkably consistently nationwide, GPCI adjustments barely move the needle for this particular code.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Laboratory category (2.24x), the estimated commercial insurance price lands near $30.98, with self-pay cash discounts commonly bringing the figure closer to $49.37. Within Laboratory, Analysis Using Chemiluminescent Technique (light And Chemical )reaction ranks #330 of 502 tracked procedures by national average Medicare payment.

What to do with this

If you may have analysis using chemiluminescent technique (light and chemical )reaction done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare analysis using chemiluminescent technique (light and chemical )reaction costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Analysis Using Chemiluminescent Technique (light And Chemical )reaction cost?

Analysis Using Chemiluminescent Technique (light And Chemical )reaction (CPT 82397) is priced fairly consistently nationwide: Medicare pays $13.83 on average, and the $13.52-$13.86 state range stays relatively tight. Providers typically bill $141.81.

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 Analysis Using Chemiluminescent Technique (light And Chemical )reaction cost with insurance?

With commercial insurance, analysis using chemiluminescent technique (light and chemical )reaction costs an estimated $30.98 on average (range: $21.68-$43.37), a moderate premium over Medicare's $13.83. Without insurance, the estimated cash price is $49.37.

Which state has the lowest cost for Analysis Using Chemiluminescent Technique (light And Chemical )reaction?

Maryland and Arizona bookend the range for Analysis Using Chemiluminescent Technique (light And Chemical )reaction, at $13.52 and $13.86 respectively - a relatively tight $0.33 spread nationwide.

How many providers perform Analysis Using Chemiluminescent Technique (light And Chemical )reaction?

Analysis Using Chemiluminescent Technique (light And Chemical )reaction is comparatively uncommon: only 198 providers nationally billed Medicare for it in 2023, serving 17.2K beneficiaries via 22.1K total services.

What is the billed-to-Medicare markup for Analysis Using Chemiluminescent Technique (light And Chemical )reaction?

Providers bill 10.3x what Medicare pays for Analysis Using Chemiluminescent Technique (light And Chemical )reaction - one of the steepest markups in the catalog at 925% above the Medicare rate.

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

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.