36907

Balloon dilation of dialysis segment with review by radiologist

Medicare pricing data for 4,726 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $130 in Nebraska to $669 in Wyoming. 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

Balloon dilation of dialysis segment with review by radiologist (HCPCS code 36907) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $366.97, but hospitals typically charge $1,282 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$73.39

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $366.97, your out-of-pocket cost would be approximately $73.39. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$366.97
Average Hospital Charge
$1,282
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,282.04
Medicare Allowed$366.97
Medicare Payment$292.71

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $292.71 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$669$1,668113+82.4%
Delaware$595$1,1618122+62.1%
Connecticut$569$2,22158446+55.0%
New York$554$1,9253034,888+50.8%
Puerto Rico$444$8251571+21.1%
New Mexico$443$2,08531318+20.8%
Michigan$431$1,1881541,449+17.4%
Maryland$417$1,2371011,324+13.6%
California$416$1,4965665,824+13.3%
Florida$408$1,0833613,197+11.0%
New Jersey$393$1,0881581,849+7.1%
Indiana$388$1,1811001,541+5.8%
Texas$378$1,3093333,023+3.0%
Alaska$371$3,70117175+1.0%
Virginia$368$1,0151411,735+0.4%
Alabama$330$80258353-10.2%
North Carolina$306$1,0451391,095-16.6%
Georgia$305$1,5311771,419-17.0%
Tennessee$300$1,05394597-18.2%
South Carolina$291$1,15472575-20.8%
Colorado$290$1,06193311-21.1%
Massachusetts$287$1,009100442-21.7%
Hawaii$283$7552291-22.8%
Pennsylvania$282$9902031,330-23.1%
Illinois$278$1,1552061,782-24.3%
South Dakota$276$1,05620102-24.8%
Arizona$273$91382757-25.6%
District of Columbia$270$1,03014187-26.5%
Oregon$265$1,15448127-27.9%
Iowa$241$1,33336125-34.4%
Washington$236$72688394-35.8%
Minnesota$220$1,19489335-40.0%
Kentucky$201$1,01868366-45.2%
Missouri$197$78794589-46.2%
Louisiana$197$79461492-46.4%
Utah$195$68133118-46.8%
Kansas$195$66127211-46.8%
Arkansas$192$83344227-47.7%
Oklahoma$173$95643277-52.9%
Ohio$166$777129752-54.7%
Mississippi$162$88242232-55.8%
Nevada$156$53335592-57.5%
Rhode Island$147$3772129-59.9%
West Virginia$142$6261447-61.3%
Maine$142$3621245-61.4%
New Hampshire$142$1,9171656-61.4%
Montana$138$8171635-62.5%
North Dakota$136$1,13617101-62.9%
Idaho$133$5702293-63.7%
Wisconsin$132$1,963106405-64.1%
Nebraska$130$1,15126116-64.5%

⚠️ 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