22614

Fusion of additional segment of spine

Medicare pricing data for 9,659 providers across 52 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $1,653 but Medicare allows only $270.34. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $195 in South Dakota to $391 in District of Columbia. 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

Fusion of additional segment of spine (HCPCS code 22614) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $270.34, but hospitals typically charge $1,653 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$54.07

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $270.34, your out-of-pocket cost would be approximately $54.07. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$270.34
Average Hospital Charge
$1,653
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,653.44
Medicare Allowed$270.34
Medicare Payment$215.83

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $215.83 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$391$1,292331,098+44.5%
Puerto Rico$347$60910102+28.3%
New York$325$2,9995229,517+20.2%
Maryland$324$1,3992256,837+19.8%
Illinois$322$2,7333276,821+19.2%
Massachusetts$316$1,8322025,441+17.0%
Vermont$308$1,8497176+13.8%
New Mexico$306$1,41234416+13.3%
Pennsylvania$303$1,6374008,313+12.0%
Rhode Island$291$2,642461,242+7.6%
Wyoming$288$1,51022363+6.4%
Florida$286$1,85174415,965+5.9%
West Virginia$286$1,17944996+5.8%
Michigan$284$1,6853116,576+5.2%
California$284$1,77379224,513+4.9%
Mississippi$283$1,77158856+4.7%
Alaska$274$3,02939901+1.5%
Missouri$274$1,3941885,367+1.4%
New Jersey$274$3,9652673,506+1.2%
Kentucky$273$1,0801212,998+0.9%
Virginia$272$1,4032396,919+0.5%
Ohio$266$1,19437611,263-1.5%
Washington$262$9372284,980-3.1%
Arizona$261$1,2832406,035-3.4%
Connecticut$261$1,9461532,451-3.6%
Minnesota$258$2,1481693,986-4.5%
Texas$256$1,35971817,155-5.3%
Georgia$255$1,3323035,447-5.5%
New Hampshire$253$2,61141518-6.3%
Louisiana$253$1,6621803,883-6.5%
Tennessee$249$1,0742256,992-7.8%
Utah$248$1,2161041,766-8.2%
Hawaii$248$76018497-8.3%
Wisconsin$246$4,3461672,800-9.1%
South Carolina$245$1,1661613,300-9.2%
Arkansas$245$1,022771,314-9.5%
North Carolina$243$1,1173419,250-10.1%
Oregon$242$1,0311182,072-10.5%
Colorado$241$1,5932457,927-10.8%
Maine$235$96838354-13.1%
Nevada$233$2,4871051,541-13.8%
Oklahoma$233$8191264,295-13.9%
Iowa$231$1,422711,958-14.5%
Montana$230$1,44942704-14.8%
Alabama$228$1,0831623,292-15.6%
Indiana$228$1,3641924,357-15.8%
Kansas$225$1,1101022,918-16.6%
North Dakota$218$80023505-19.2%
Nebraska$213$1,168731,350-21.3%
Delaware$205$1,578461,502-24.4%
Idaho$204$2,183811,550-24.7%
South Dakota$195$97256815-27.9%

⚠️ 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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