00812

Anesthesia for exam of colon using an endoscope

Medicare pricing data for 63,815 providers across 52 states

🤖AI Overview

This procedure has a 11.5x markup — hospitals charge $951.03 but Medicare allows only $82.47. Uninsured patients may face bills 11.5 times higher than what insurance negotiates. 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 exam of colon using an endoscope (HCPCS code 00812) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $82.47, but hospitals typically charge $951.03 — a 11.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.49

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $82.47, your out-of-pocket cost would be approximately $16.49. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$82.47
Average Hospital Charge
$951.03
Markup Ratio
11.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$951.03
Medicare Allowed$82.47
Medicare Payment$82.47

Hospitals charge 11.5x more than what Medicare allows for this procedure. Medicare actually pays $82.47 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$125$958121823+51.1%
California$105$1,1043,46533,920+26.8%
Montana$103$7171842,579+24.9%
Wyoming$100$858791,131+20.7%
Washington$97$8281,0169,766+18.1%
Puerto Rico$97$1,41639535+17.8%
Idaho$97$6702012,031+17.4%
Maryland$95$1,0611,03118,554+15.8%
New Mexico$95$1,1972462,529+15.5%
Oregon$95$8214763,645+14.7%
Utah$94$7854533,761+14.3%
Iowa$94$7364493,808+14.2%
Nevada$94$9252743,188+14.2%
New York$94$1,4353,68142,952+14.0%
Hawaii$93$6591351,022+13.2%
Arkansas$91$7224756,107+10.7%
Nebraska$90$6854273,812+9.5%
Oklahoma$90$9086227,836+9.2%
Arizona$90$1,6421,01912,920+8.9%
Illinois$89$1,0092,50125,708+8.1%
Colorado$88$9979278,585+7.2%
Indiana$88$7911,22712,499+6.5%
Vermont$87$6491061,051+5.2%
Kansas$86$6547649,224+4.4%
New Jersey$86$1,0541,60822,781+4.3%
Louisiana$85$7721,03810,167+3.4%
Kentucky$85$7731,12311,493+2.8%
Florida$85$1,0984,38747,995+2.6%
Tennessee$84$8821,82417,250+1.8%
Ohio$82$7052,84825,898-0.8%
Missouri$82$8701,70717,504-0.9%
Texas$81$1,1415,16550,886-2.2%
Rhode Island$80$1,3511942,916-2.7%
Virginia$80$8461,79930,696-2.8%
Mississippi$79$7235747,651-3.7%
District of Columbia$79$7953042,466-4.2%
New Hampshire$79$9224035,355-4.4%
North Carolina$79$8132,27725,810-4.5%
North Dakota$77$1,3162202,748-6.1%
Delaware$77$9822184,213-6.9%
West Virginia$75$9034634,316-8.6%
Georgia$73$9242,37423,526-11.2%
Wisconsin$73$1,1201,38811,537-11.2%
South Carolina$73$8331,28817,646-11.8%
Connecticut$72$9649669,748-12.2%
Maine$70$7094483,980-14.6%
Massachusetts$70$7491,80529,467-14.9%
Pennsylvania$70$6983,95650,710-15.1%
South Dakota$68$8562982,520-18.1%
Michigan$67$8612,75625,235-18.2%
Minnesota$65$6911,2558,994-21.0%
Alabama$64$8701,15211,520-22.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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