Delaware · 86140

Measurement C-Reactive Protein For Detection Of Infection Or Inflammation in Delaware

Delaware Medicare Avg
$5.08
0% above national avg
National Medicare Avg
$5.07
All states combined
Billed Charge (DE)
$39.14
What providers submit
Est. Commercial (DE)
$11.43
National avg: $11.35
Est. Cash / Self-Pay (DE)
$14.57
Typical self-pay discount

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

113
Services in DE
4
Providers
N/A
Min Payment
N/A
Max Payment

Delaware Pricing in Context

In Delaware, CPT code 86140 (Measurement C-Reactive Protein For Detection Of Infection Or Inflammation) carries an average Medicare payment of $5.08 — 0% above the national benchmark of $5.07. 4 providers across the state submitted claims for this procedure in 2023, performing 113 total services. Individual payments in DE 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 Delaware is $39.14, 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 Delaware sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Laboratory procedures, the estimated commercial insurance price in Delaware lands near $11.43, with self-pay cash prices typically around $14.57. 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 Measurement C-Reactive Protein For Detection Of Infection Or Inflammation cost in Delaware?

The average Medicare payment for Measurement C-Reactive Protein For Detection Of Infection Or Inflammation in Delaware is $5.08, which is 0% above the national average of $5.07. Providers in DE typically bill $39.14 for this procedure.

What does Measurement C-Reactive Protein For Detection Of Infection Or Inflammation cost with insurance in Delaware?

With commercial insurance in Delaware, Measurement C-Reactive Protein For Detection Of Infection Or Inflammation costs an estimated $11.43. Without insurance, the estimated cash price is $14.57. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Measurement C-Reactive Protein For Detection Of Infection Or Inflammation in Delaware?

4 providers in Delaware billed Medicare for Measurement C-Reactive Protein For Detection Of Infection Or Inflammation in 2023, performing 113 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Measurement C-Reactive Protein For Detection Of Infection Or Inflammation cheaper in Delaware than the national average?

No — Measurement C-Reactive Protein For Detection Of Infection Or Inflammation costs 0% above the national average in Delaware. The state average Medicare payment is $5.08 compared to $5.07 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