Anesthesia for reconstruction of breast
Medicare pricing data for 18,594 providers across 51 states
This procedure has a 10.3x markup — hospitals charge $2,371 but Medicare allows only $230.23. Uninsured patients may face bills 10.3 times higher than what insurance negotiates. Prices vary significantly by location — from $161 in Alabama to $508 in Alaska. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Anesthesia for reconstruction of breast (HCPCS code 00402) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $230.23, but hospitals typically charge $2,371 — a 10.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $230.23, your out-of-pocket cost would be approximately $46.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 10.3x more than what Medicare allows for this procedure. Medicare actually pays $180.57 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $508 | $2,918 | 19 | 25 | +120.6% |
| Montana | $365 | $2,050 | 70 | 103 | +58.4% |
| Idaho | $343 | $2,390 | 54 | 71 | +48.8% |
| Hawaii | $324 | $2,298 | 33 | 37 | +40.9% |
| California | $323 | $2,466 | 1,558 | 2,706 | +40.2% |
| Louisiana | $315 | $2,514 | 230 | 464 | +37.0% |
| Utah | $305 | $2,040 | 132 | 181 | +32.4% |
| Washington | $280 | $2,064 | 400 | 631 | +21.7% |
| Iowa | $274 | $1,852 | 149 | 195 | +19.2% |
| Delaware | $274 | $2,320 | 79 | 118 | +18.9% |
| Oregon | $274 | $1,703 | 187 | 269 | +18.9% |
| Nevada | $267 | $2,324 | 98 | 191 | +15.9% |
| Arizona | $267 | $3,225 | 347 | 605 | +15.9% |
| Indiana | $265 | $2,157 | 269 | 404 | +15.2% |
| Arkansas | $260 | $1,654 | 98 | 173 | +12.8% |
| Maryland | $258 | $2,205 | 345 | 569 | +12.1% |
| Wyoming | $252 | $1,910 | 11 | 12 | +9.2% |
| Oklahoma | $244 | $2,186 | 170 | 279 | +5.9% |
| New Jersey | $240 | $2,841 | 461 | 744 | +4.3% |
| New York | $240 | $3,189 | 1,201 | 2,262 | +4.1% |
| Colorado | $239 | $2,388 | 297 | 427 | +3.9% |
| Nebraska | $239 | $1,395 | 125 | 186 | +3.8% |
| New Mexico | $237 | $2,337 | 62 | 104 | +2.8% |
| Texas | $233 | $2,723 | 1,300 | 2,282 | +1.4% |
| Florida | $228 | $2,527 | 1,391 | 2,348 | -1.0% |
| Kentucky | $226 | $2,719 | 217 | 319 | -1.6% |
| West Virginia | $225 | $3,147 | 75 | 98 | -2.1% |
| Illinois | $225 | $2,730 | 742 | 1,133 | -2.2% |
| Vermont | $224 | $1,618 | 24 | 37 | -2.7% |
| Connecticut | $222 | $2,862 | 266 | 377 | -3.7% |
| Ohio | $221 | $1,883 | 655 | 889 | -4.1% |
| District of Columbia | $218 | $2,009 | 108 | 200 | -5.2% |
| Massachusetts | $213 | $1,713 | 608 | 1,044 | -7.6% |
| Missouri | $213 | $1,567 | 401 | 663 | -7.6% |
| Rhode Island | $212 | $1,704 | 54 | 79 | -7.7% |
| Wisconsin | $212 | $3,169 | 373 | 520 | -8.1% |
| Maine | $209 | $2,191 | 81 | 103 | -9.3% |
| Tennessee | $208 | $2,238 | 475 | 776 | -9.7% |
| North Dakota | $203 | $1,511 | 71 | 106 | -12.0% |
| Michigan | $199 | $2,981 | 615 | 918 | -13.4% |
| New Hampshire | $199 | $2,894 | 117 | 166 | -13.8% |
| Pennsylvania | $194 | $1,966 | 924 | 1,449 | -15.6% |
| Virginia | $191 | $2,347 | 632 | 1,103 | -17.1% |
| Kansas | $190 | $1,362 | 255 | 501 | -17.6% |
| South Carolina | $179 | $2,483 | 417 | 731 | -22.3% |
| North Carolina | $178 | $2,273 | 672 | 1,077 | -22.8% |
| Mississippi | $176 | $1,170 | 121 | 273 | -23.8% |
| Minnesota | $174 | $1,651 | 406 | 575 | -24.2% |
| Georgia | $170 | $1,893 | 775 | 1,331 | -26.1% |
| South Dakota | $164 | $1,663 | 114 | 207 | -28.8% |
| Alabama | $161 | $1,857 | 264 | 414 | -30.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber