Immunology · 84182

Protein Measurement, Immunological Probe For Band Identification

Medicare Payment (avg)
$28.34
What Medicare actually pays
Billed Charge (avg)
$127.12
What providers submit
Markup
4.5x
349% above Medicare rate
48.3K
Total Services
11.2K
Beneficiaries
134
Providers
28
States with Data

Price Range Across States

Lowest State Avg
$27.08
Washington
Highest State Avg
$28.63
Tennessee

What You Might Pay

Est. Commercial Insurance
$63.55
Range: $44.49 – $88.98
Est. Cash / Self-Pay
$56.24
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: Immunology 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
Tennessee $28.63 $43.15
New York $28.63 $163.49
Arizona $28.63 $76.49
Hawaii $28.63 $143.58
Wisconsin $28.63 $186.79
Maryland $28.63 $145.90
Colorado $28.63 $145.62
Kansas $28.63 $151.61
Oklahoma $28.63 $161.85
Pennsylvania $28.63 $116.59
Georgia $28.63 $150.37
Illinois $28.63 $148.68
Nevada $28.63 $212.70
New Mexico $28.63 $48.89
Florida $28.62 $159.86
New Jersey $28.57 $153.94
Utah $28.55 $61.38
Missouri $28.42 $164.95
Texas $28.41 $141.52
Minnesota $28.36 $258.37
North Carolina $28.32 $152.15
Virginia $28.25 $114.35
Iowa $28.22 $345.84
California $28.13 $79.45
Ohio $27.85 $83.09
Indiana $27.74 $78.90
Massachusetts $27.21 $149.41
Washington $27.08 $156.01

What the Data Says About Protein Measurement, Immunological Probe For Band Identification

Across 28 states with reporting providers, CPT code 84182 (Protein Measurement, Immunological Probe For Band Identification) shows a national average Medicare payment of $28.34 against an average billed charge of $127.12. That gap — a 4.5x markup, or 349% 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.

Immunology procedures like this one saw 48.3K services billed to Medicare in 2023 by 134 distinct providers, serving 11.2K unique beneficiaries. State-level variation is significant: Washington reports the lowest average payment at $27.08, while Tennessee reports the highest at $28.63. 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 Immunology category (2.24x), the estimated commercial insurance price lands near $63.55, with self-pay cash discounts commonly bringing the figure closer to $56.24. 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 Protein Measurement, Immunological Probe For Band Identification cost?

The national average Medicare payment for Protein Measurement, Immunological Probe For Band Identification (CPT 84182) is $28.34, while providers typically bill $127.12. Prices vary significantly by state, ranging from $27.08 to $28.63.

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 Protein Measurement, Immunological Probe For Band Identification cost with insurance?

With commercial insurance, Protein Measurement, Immunological Probe For Band Identification costs an estimated $63.55 on average (range: $44.49 – $88.98). Without insurance, the estimated cash price is $56.24. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.

Which state has the lowest cost for Protein Measurement, Immunological Probe For Band Identification?

Washington has the lowest average Medicare payment for Protein Measurement, Immunological Probe For Band Identification at $27.08, while Tennessee has the highest at $28.63. This $1.55 difference reflects geographic variation in healthcare costs, local cost of living, and provider market dynamics.

How many providers perform Protein Measurement, Immunological Probe For Band Identification?

Nationally, 134 providers billed Medicare for Protein Measurement, Immunological Probe For Band Identification in 2023, performing 48.3K total services for 11.2K beneficiaries across 28 states and territories.

What is the billed-to-Medicare markup for Protein Measurement, Immunological Probe For Band Identification?

Providers bill 4.5x what Medicare pays for Protein Measurement, Immunological Probe For Band Identification — a 349% 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

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