36903

Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist

Medicare pricing data for 2,670 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $275 in Idaho to $4,230 in Delaware. 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 needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist (HCPCS code 36903) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $3,026, but hospitals typically charge $10,708 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$605.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $3,026, your out-of-pocket cost would be approximately $605.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$3,026
Average Hospital Charge
$10,708
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$10,707.52
Medicare Allowed$3,025.52
Medicare Payment$2,407.42

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $2,407 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$4,230$8,710641+39.8%
Connecticut$4,169$15,14132151+37.8%
New York$4,002$12,3911631,139+32.3%
New Jersey$3,890$11,7651121,168+28.6%
Hawaii$3,812$9,96614129+26.0%
California$3,731$13,3642901,852+23.3%
Rhode Island$3,475$12,189468+14.8%
North Carolina$3,350$10,98177679+10.7%
Virginia$3,307$10,39675451+9.3%
Arizona$3,265$15,35946514+7.9%
Maryland$3,212$8,81776361+6.2%
Nevada$3,206$11,48419212+6.0%
Illinois$3,098$10,600110741+2.4%
Texas$2,959$10,8362231,301-2.2%
Georgia$2,859$12,547117459-5.5%
Alabama$2,854$8,41242185-5.7%
Kansas$2,851$6,25419228-5.8%
Florida$2,815$9,804204907-7.0%
Wisconsin$2,766$12,50545283-8.6%
Utah$2,766$9,7041276-8.6%
Indiana$2,698$10,66751276-10.8%
Pennsylvania$2,588$10,763100550-14.4%
Ohio$2,484$9,75073311-17.9%
New Mexico$2,365$12,1731556-21.8%
Tennessee$2,358$8,71677242-22.1%
Michigan$2,180$7,33883373-27.9%
Mississippi$2,178$10,44323133-28.0%
Colorado$2,092$8,0443153-30.9%
Arkansas$2,088$8,9432588-31.0%
Louisiana$2,003$9,66747324-33.8%
South Carolina$1,888$6,52444170-37.6%
Minnesota$1,798$7,8404590-40.6%
Massachusetts$1,619$6,30560196-46.5%
Washington$1,370$4,62934138-54.7%
Nebraska$1,223$10,2661667-59.6%
Missouri$1,201$6,39951156-60.3%
Kentucky$1,113$4,7834394-63.2%
Oklahoma$342$1,22429126-88.7%
District of Columbia$313$1,082540-89.7%
Wyoming$309$5,031316-89.8%
New Hampshire$306$1,9191119-89.9%
Maine$304$740412-90.0%
Montana$290$3,4381017-90.4%
West Virginia$286$1,6421123-90.5%
South Dakota$285$640924-90.6%
Iowa$281$1,7501125-90.7%
Oregon$278$1,0071015-90.8%
Idaho$275$9641123-90.9%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber