01230

Anesthesia for procedure on upper 2/3rd of thigh bone

Medicare pricing data for 49,472 providers across 52 states

🤖AI Overview

This procedure has a 10.3x markup — hospitals charge $2,077 but Medicare allows only $202.25. Uninsured patients may face bills 10.3 times higher than what insurance negotiates. Prices vary significantly by location — from $150 in Alabama to $346 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 procedure on upper 2/3rd of thigh bone (HCPCS code 01230) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $202.25, but hospitals typically charge $2,077 — a 10.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$40.45

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $202.25, your out-of-pocket cost would be approximately $40.45. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$202.25
Average Hospital Charge
$2,077
Markup Ratio
10.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,077.25
Medicare Allowed$202.25
Medicare Payment$159.46

Hospitals charge 10.3x more than what Medicare allows for this procedure. Medicare actually pays $159.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$346$2,15796213+70.9%
California$285$2,2362,9498,544+40.9%
Utah$282$1,787310666+39.4%
Puerto Rico$280$1,80959142+38.3%
Oregon$277$1,834411972+36.8%
Montana$274$1,582158422+35.4%
Wyoming$273$2,29660172+34.8%
Idaho$266$1,820197486+31.3%
Washington$262$1,9059512,346+29.6%
Nebraska$247$1,617380988+22.2%
Iowa$244$1,6164511,314+20.6%
Hawaii$242$1,61692233+19.4%
Arkansas$236$1,4224591,605+16.7%
New Mexico$235$2,163251684+16.1%
New York$233$2,9332,5577,810+15.1%
Arizona$233$2,6388412,655+15.1%
District of Columbia$232$1,988197478+14.9%
Nevada$231$2,245288886+14.1%
New Jersey$228$2,7811,1333,681+12.8%
Maryland$223$2,3038072,712+10.5%
Indiana$221$1,8349612,757+9.1%
Oklahoma$221$2,0495031,648+9.0%
Kansas$219$1,4066031,814+8.2%
Illinois$217$2,6591,8525,798+7.4%
Delaware$213$1,965189634+5.5%
Colorado$209$1,9817911,913+3.1%
Massachusetts$208$1,6881,3214,582+2.8%
Kentucky$208$1,7588222,362+2.8%
Rhode Island$208$1,783125404+2.7%
Florida$205$2,3353,59410,945+1.4%
Vermont$204$1,323111337+0.8%
Wisconsin$196$2,7951,0722,606-2.9%
Tennessee$194$1,8611,3783,822-4.1%
Texas$193$2,4263,63010,250-4.5%
Louisiana$193$1,5807402,228-4.7%
New Hampshire$193$2,400306974-4.8%
Ohio$190$1,6042,2335,946-6.1%
Missouri$188$1,6331,2483,915-7.0%
Connecticut$187$2,2656732,057-7.5%
North Dakota$176$1,572246832-12.9%
Virginia$173$2,0641,3844,684-14.4%
Michigan$171$2,2411,8315,167-15.4%
Maine$170$1,853335944-16.1%
West Virginia$169$1,6203831,108-16.7%
Mississippi$168$1,2334681,936-16.9%
Pennsylvania$166$1,8282,9338,868-17.8%
Minnesota$165$1,6011,1923,184-18.6%
Georgia$159$1,7211,7265,474-21.3%
North Carolina$159$2,0351,8035,292-21.4%
South Dakota$153$1,739247822-24.5%
South Carolina$152$2,0291,1113,777-24.6%
Alabama$150$1,4629473,116-25.8%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber