36246

Insertion of tube into abdominal, pelvic, or leg artery, initial second order branch

Medicare pricing data for 7,524 providers across 52 states

🤖AI Overview

This procedure has a 6.7x markup — hospitals charge $1,960 but Medicare allows only $290.65. Uninsured patients may face bills 6.7 times higher than what insurance negotiates. Prices vary significantly by location — from $143 in Puerto Rico to $378 in Florida. 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, initial second order branch (HCPCS code 36246) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $290.65, but hospitals typically charge $1,960 — a 6.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$58.13

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $290.65, your out-of-pocket cost would be approximately $58.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$290.65
Average Hospital Charge
$1,960
Markup Ratio
6.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,960.08
Medicare Allowed$290.65
Medicare Payment$230.61

Hospitals charge 6.7x more than what Medicare allows for this procedure. Medicare actually pays $230.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$378$1,8656192,516+29.9%
California$370$2,1446433,513+27.3%
Connecticut$365$3,19693235+25.5%
Mississippi$363$1,93070205+24.8%
Arizona$356$1,762177581+22.6%
Maryland$351$1,244151527+20.6%
Delaware$350$1,4423184+20.5%
Michigan$325$1,258259796+11.9%
Georgia$307$2,728205638+5.8%
New Jersey$306$1,986198536+5.2%
Texas$300$2,2156522,084+3.3%
Louisiana$298$2,440139419+2.5%
New York$290$2,8134601,630-0.1%
Nevada$285$1,78658201-2.1%
Virginia$281$1,436230728-3.2%
Illinois$281$2,6613501,106-3.4%
Massachusetts$262$2,601176603-10.0%
Oklahoma$253$1,302125500-13.0%
Alabama$248$1,16095280-14.7%
Tennessee$241$1,447168419-17.2%
Arkansas$233$1,01090321-19.8%
South Carolina$233$1,664130372-19.9%
North Carolina$229$2,096236732-21.3%
Ohio$226$1,378239694-22.3%
Kansas$223$1,30162233-23.3%
Alaska$223$3,8231118-23.3%
Pennsylvania$221$1,6113401,152-23.9%
Oregon$221$1,35789234-24.1%
Nebraska$218$2,36043208-25.0%
District of Columbia$216$1,05425142-25.8%
Washington$211$1,001135394-27.3%
Rhode Island$210$1,8252155-27.8%
Kentucky$210$1,71688277-27.9%
Missouri$208$1,599157533-28.3%
Indiana$207$2,087164462-28.7%
West Virginia$198$9673487-31.9%
Wisconsin$196$3,384162358-32.5%
Maine$195$1,35928110-32.8%
Vermont$195$3,868925-32.9%
Montana$193$1,1672286-33.6%
New Hampshire$191$2,31549144-34.2%
New Mexico$187$1,4742564-35.5%
Colorado$182$1,105101215-37.3%
Minnesota$180$1,471111325-38.0%
Hawaii$180$1,0181119-38.2%
Utah$178$1,2683773-38.8%
South Dakota$174$7253098-40.0%
Wyoming$173$1,5301033-40.4%
Iowa$171$2,11656152-41.2%
North Dakota$166$1,9432063-42.8%
Idaho$163$1,2353890-44.0%
Puerto Rico$143$785936-50.7%

⚠️ 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