36245

Insertion of tube into abdominal, pelvic, or leg artery, each first order branch

Medicare pricing data for 7,309 providers across 52 states

🤖AI Overview

This procedure has a 8.4x markup — hospitals charge $2,177 but Medicare allows only $260.59. Uninsured patients may face bills 8.4 times higher than what insurance negotiates. Prices vary significantly by location — from $117 in Idaho to $641 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

Insertion of tube into abdominal, pelvic, or leg artery, each first order branch (HCPCS code 36245) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $260.59, but hospitals typically charge $2,177 — a 8.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$52.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $260.59, your out-of-pocket cost would be approximately $52.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$260.59
Average Hospital Charge
$2,177
Markup Ratio
8.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,176.73
Medicare Allowed$260.59
Medicare Payment$207.29

Hospitals charge 8.4x more than what Medicare allows for this procedure. Medicare actually pays $207.29 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$641$1,77122390+146.1%
Florida$436$2,2106112,892+67.4%
Arizona$357$2,382166835+37.0%
Delaware$345$1,70724117+32.5%
California$328$2,5226483,191+25.9%
Louisiana$318$2,501132357+22.2%
Maryland$310$1,522137578+19.0%
New York$296$3,5634301,717+13.7%
Texas$277$2,2626031,943+6.3%
Arkansas$264$1,33587333+1.2%
Nevada$262$2,24065201+0.5%
New Jersey$253$2,216200604-2.8%
Georgia$252$3,121206740-3.2%
New Mexico$250$2,53623105-4.2%
Mississippi$249$2,01561161-4.6%
Michigan$246$1,184279842-5.5%
Oregon$242$1,997101377-7.1%
Pennsylvania$242$1,9353211,030-7.1%
Connecticut$236$3,99878219-9.6%
South Dakota$231$1,12931194-11.2%
Iowa$230$3,33860278-11.8%
Utah$226$1,42142106-13.4%
Tennessee$222$1,612175691-14.8%
Massachusetts$212$2,290170768-18.7%
Oklahoma$204$1,084112461-21.9%
Alabama$187$1,117105427-28.1%
Alaska$180$5,512931-31.0%
Puerto Rico$179$1,619828-31.4%
Virginia$177$2,031196831-31.9%
North Carolina$177$2,486238920-32.1%
Washington$170$1,408141524-34.7%
Illinois$168$2,0983201,109-35.6%
Wyoming$167$1,9321021-35.9%
Indiana$167$2,184160491-35.9%
Colorado$162$1,382100339-37.8%
Montana$160$1,26530178-38.5%
Wisconsin$155$3,302156491-40.6%
South Carolina$149$1,817106489-42.8%
Vermont$147$6,1231350-43.5%
West Virginia$144$1,03935163-44.7%
Missouri$144$1,734159634-44.9%
Maine$143$1,0562257-45.0%
Ohio$139$1,551250911-46.5%
Kansas$138$1,05861263-47.0%
New Hampshire$138$2,40942169-47.2%
Rhode Island$135$1,4222659-48.3%
Kentucky$133$1,32187284-49.0%
Hawaii$129$7711644-50.4%
North Dakota$126$1,9532697-51.5%
Nebraska$121$2,25139173-53.5%
Minnesota$121$1,872102453-53.5%
Idaho$117$1,54835127-55.2%

⚠️ 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