00860

Anesthesia for other procedure on lower abdomen outside abdominal cavity

Medicare pricing data for 29,955 providers across 52 states

🤖AI Overview

This procedure has a 10.3x markup — hospitals charge $2,095 but Medicare allows only $203.75. Uninsured patients may face bills 10.3 times higher than what insurance negotiates. Prices vary significantly by location — from $141 in South Dakota to $338 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 other procedure on lower abdomen outside abdominal cavity (HCPCS code 00860) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $203.75, but hospitals typically charge $2,095 — a 10.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$40.75

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $203.75, your out-of-pocket cost would be approximately $40.75. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$203.75
Average Hospital Charge
$2,095
Markup Ratio
10.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,094.53
Medicare Allowed$203.75
Medicare Payment$160.64

Hospitals charge 10.3x more than what Medicare allows for this procedure. Medicare actually pays $160.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$338$2,0464776+66.0%
Montana$289$1,69792138+41.9%
Nevada$282$2,515135223+38.6%
Hawaii$275$2,0845585+35.0%
Puerto Rico$274$1,7052655+34.4%
Idaho$273$1,86798148+33.8%
California$272$2,1811,9283,674+33.4%
New Mexico$270$2,469108154+32.3%
Delaware$265$2,24895177+30.2%
Utah$255$1,713221382+24.9%
Oregon$254$1,602317508+24.8%
Iowa$248$1,592219338+21.7%
Wyoming$244$1,4792644+19.9%
Arizona$244$2,8815881,212+19.6%
Maryland$241$2,2335461,035+18.2%
Washington$241$1,861607994+18.1%
Oklahoma$228$1,899302636+11.9%
Colorado$226$2,231440662+11.1%
Indiana$221$1,780511841+8.7%
New York$220$2,6761,7843,541+7.9%
Kentucky$217$1,905369573+6.6%
New Jersey$212$2,1747951,689+4.0%
Florida$209$2,3432,2074,074+2.6%
Massachusetts$208$1,6539211,741+2.2%
Illinois$207$2,3941,0791,860+1.7%
District of Columbia$207$1,743175305+1.6%
Louisiana$207$1,524435762+1.6%
Nebraska$207$1,246216482+1.5%
Kansas$204$1,284377777+0.1%
Wisconsin$202$2,951542872-0.8%
Connecticut$202$2,596341555-0.9%
Rhode Island$201$1,82578151-1.4%
Tennessee$201$1,9758751,498-1.6%
New Hampshire$198$2,967158293-2.8%
Texas$193$2,4872,3524,557-5.3%
Vermont$191$1,2114780-6.3%
Arkansas$190$1,186268744-6.9%
Ohio$189$1,6201,3582,274-7.1%
Virginia$188$2,5197461,330-7.8%
Minnesota$183$1,7276471,117-10.3%
Missouri$179$1,4726471,156-12.1%
North Dakota$178$1,470101159-12.8%
Michigan$177$2,6331,0731,681-13.2%
Pennsylvania$174$1,8111,6232,871-14.7%
Georgia$170$1,8131,1062,076-16.5%
Mississippi$168$1,190228415-17.4%
Maine$165$1,816155230-19.3%
South Carolina$161$2,1687181,522-21.1%
North Carolina$160$2,0051,0802,044-21.6%
West Virginia$148$1,971238446-27.1%
Alabama$142$1,4546371,280-30.2%
South Dakota$141$1,627141236-31.0%

⚠️ 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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