31627

Computer-assisted image-guided navigation of lung airways using an endoscope

Medicare pricing data for 2,080 providers across 49 states

🤖AI Overview

This procedure has a 18.8x markup — hospitals charge $1,798 but Medicare allows only $95.54. Uninsured patients may face bills 18.8 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

Computer-assisted image-guided navigation of lung airways using an endoscope (HCPCS code 31627) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $95.54, but hospitals typically charge $1,798 — a 18.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$19.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $95.54, your out-of-pocket cost would be approximately $19.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$95.54
Average Hospital Charge
$1,798
Markup Ratio
18.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,798.11
Medicare Allowed$95.54
Medicare Payment$75.94

Hospitals charge 18.8x more than what Medicare allows for this procedure. Medicare actually pays $75.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$126$1,486122+31.9%
California$105$2,6831402,020+10.3%
New York$105$3,873921,076+10.0%
District of Columbia$102$75811271+6.3%
New Jersey$99$2,70140336+3.9%
Connecticut$99$1,83625281+3.2%
Illinois$98$1,980791,224+2.5%
Massachusetts$98$1,56255651+2.2%
Maryland$98$1,96032658+2.2%
Virginia$96$2,00154591+0.6%
Florida$95$1,3011852,019-0.5%
Texas$95$1,6631451,555-0.7%
Hawaii$95$9108131-0.8%
New Hampshire$95$1,482366-0.8%
Montana$95$1,046785-1.0%
Washington$95$93635432-1.1%
Pennsylvania$94$1,7151181,239-1.3%
Delaware$94$1,5259168-1.3%
Michigan$94$72385619-1.8%
New Mexico$94$2,675414-2.0%
Nevada$93$2,75522200-2.2%
Arizona$93$88830631-2.7%
Colorado$93$1,12525256-2.8%
Louisiana$93$1,70628336-2.9%
West Virginia$93$84325114-3.1%
Rhode Island$93$1,212744-3.2%
Oregon$93$2,77116149-3.2%
Georgia$92$1,74275924-3.3%
Ohio$92$692101808-3.3%
Missouri$92$1,29454472-3.6%
South Carolina$92$1,32134497-3.8%
Utah$92$1,234569-4.1%
Minnesota$91$1,75534373-4.6%
Kentucky$90$61452505-5.3%
North Dakota$90$2,538420-5.5%
Oklahoma$90$1,45518215-5.8%
Alabama$90$1,63627295-5.9%
South Dakota$90$2,643218-5.9%
North Carolina$90$2,965771,071-6.1%
Mississippi$89$2,30232301-7.1%
Idaho$89$384881-7.2%
Indiana$89$1,81371838-7.3%
Kansas$88$50515205-7.5%
Iowa$88$1,97726230-7.5%
Tennessee$88$1,271741,239-7.5%
Wisconsin$87$2,40747426-8.5%
Arkansas$87$2,1996102-8.5%
Nebraska$86$2,34120205-9.5%
Vermont$83$3,264545-13.1%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber