Laboratory · 83986

Body Fluid Ph Level

What Medicare pays for 83986, what providers bill, and how the price varies across 46 states, drawn from CMS 2023 claims data.

83986 · the short answer

For body fluid ph level, Medicare pays about $3.51 on average across 46 states. This is a low-payment administrative or drug code, so the billed-to-paid ratio is not a meaningful "markup."

Medicare pays
$3.51
Providers bill
$15.01
States with data
46

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

Medicare Payment (avg)
$3.51
What Medicare actually pays
Billed Charge (avg)
$15.01
What providers submit
Markup
4.3x
328% above Medicare rate
87.4K
Total Services
65.7K
Beneficiaries
1.6K
Providers
46
States with Data

Price Range Across States

Lowest State Avg
$2.75
Maryland
Highest State Avg
$3.52
Georgia

What You Might Pay

Est. Commercial Insurance
$7.85
Range: $5.50 – $10.99
Est. Cash / Self-Pay
$6.76
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.

Prices by State

State Medicare Payment Billed Charge
Georgia $3.52 $38.14
Utah $3.51 $7.42
Idaho $3.51 $7.52
Iowa $3.51 $21.41
Kentucky $3.51 $14.09
Nebraska $3.51 $11.95
Ohio $3.51 $10.96
Rhode Island $3.51 $15.77
Vermont $3.51 $21.05
Virginia $3.51 $22.24
Alaska $3.51 $36.39
Colorado $3.51 $18.16
District of Columbia $3.51 $28.13
Maine $3.51 $10.18
West Virginia $3.51 $12.66
Illinois $3.51 $13.19
Minnesota $3.51 $28.59
Oklahoma $3.51 $15.09
Missouri $3.51 $14.69
Kansas $3.51 $16.47
New Jersey $3.51 $10.74
Florida $3.51 $17.05
Massachusetts $3.51 $16.46
Arizona $3.50 $21.00
California $3.50 $21.32
Texas $3.50 $23.30
Nevada $3.50 $45.80
Connecticut $3.50 $17.51
Oregon $3.50 $15.14
Pennsylvania $3.50 $11.30
Wisconsin $3.49 $36.13
Hawaii $3.49 $15.26
North Carolina $3.49 $29.82
Tennessee $3.49 $15.14
Michigan $3.48 $9.26
New York $3.48 $13.22
South Carolina $3.48 $19.49
Washington $3.48 $32.23
Indiana $3.48 $14.97
Louisiana $3.46 $36.73
Arkansas $3.45 $14.68
New Hampshire $3.45 $15.03
New Mexico $3.42 $20.73
Alabama $3.39 $19.25
Delaware $3.30 $12.04
Maryland $2.75 $20.63

What the Data Says About Body Fluid Ph Level

Across 46 states with reporting providers, CPT code 83986 (Body Fluid Ph Level) shows a national average Medicare payment of $3.51 against an average billed charge of $15.01. That gap, a 4.3x markup, or 328% above the Medicare allowed amount, is not a meaningful ratio for this low-payment code, so treat the billed figure as a chargemaster reference point rather than a real-world price.

Laboratory procedures like this one saw 87.4K services billed to Medicare in 2023 by 1.6K distinct providers, serving 65.7K unique beneficiaries. State-level variation is significant: Maryland reports the lowest average payment at $2.75, while Georgia reports the highest at $3.52. The 28% spread here is a moderate, fairly ordinary GPCI effect, local cost-of-practice adjustments nudging the allowed amount up or down without reshaping it.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Laboratory category (2.24x), the estimated commercial insurance price lands near $7.85, with self-pay cash discounts commonly bringing the figure closer to $6.76. Within Laboratory, Body Fluid Ph Level ranks #500 of 502 tracked procedures by national average Medicare payment.

What to do with this

If you may have body fluid ph level 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 body fluid ph level 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 Body Fluid Ph Level cost?

Body Fluid Ph Level (CPT 83986) is priced fairly consistently nationwide: Medicare pays $3.51 on average, and the $2.75-$3.52 state range stays relatively tight. Providers typically bill $15.01.

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 Body Fluid Ph Level cost with insurance?

With commercial insurance, body fluid ph level costs an estimated $7.85 on average (range: $5.50-$10.99), a moderate premium over Medicare's $3.51. Without insurance, the estimated cash price is $6.76.

Which state has the lowest cost for Body Fluid Ph Level?

Maryland and Georgia bookend the range for Body Fluid Ph Level, at $2.75 and $3.52 respectively - a relatively tight $0.77 spread nationwide.

How many providers perform Body Fluid Ph Level?

A moderate provider base performs Body Fluid Ph Level: 1.6K providers nationally, totaling 87.4K Medicare-billed services (65.7K beneficiaries) across 46 states in 2023.

What is the billed-to-Medicare markup for Body Fluid Ph Level?

Providers bill 4.3x what Medicare pays for Body Fluid Ph Level - a markup within the typical range at 328% 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.