44204

Partial removal of large bowel using an endoscope

Medicare pricing data for 5,136 providers across 51 states

🤖AI Overview

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

Partial removal of large bowel using an endoscope (HCPCS code 44204) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,203, but hospitals typically charge $4,474 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$240.59

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,203, your out-of-pocket cost would be approximately $240.59. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,203
Average Hospital Charge
$4,474
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,474.31
Medicare Allowed$1,202.93
Medicare Payment$958.15

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $958.15 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,463$11,1863058+21.6%
Virginia$1,400$3,986117289+16.4%
Maryland$1,397$4,72286242+16.1%
Illinois$1,327$5,098159297+10.3%
Massachusetts$1,317$4,368121271+9.5%
New York$1,302$6,093342807+8.3%
Texas$1,294$4,834300575+7.5%
Ohio$1,288$4,091180327+7.0%
Kentucky$1,285$3,35490191+6.8%
Oklahoma$1,276$3,58257121+6.1%
New Mexico$1,275$4,4731941+6.0%
Tennessee$1,269$3,998104205+5.5%
Hawaii$1,268$3,6721832+5.4%
New Jersey$1,249$10,144138354+3.9%
Nevada$1,248$4,2003970+3.7%
District of Columbia$1,244$3,7481236+3.4%
Louisiana$1,243$3,81991213+3.4%
California$1,239$4,5214591,089+3.0%
Michigan$1,234$3,641160324+2.6%
Arkansas$1,229$3,1924798+2.2%
Pennsylvania$1,226$3,733196401+1.9%
Georgia$1,221$4,086139269+1.5%
Connecticut$1,218$4,8365493+1.2%
Florida$1,201$3,929351927-0.1%
Missouri$1,196$4,013114246-0.6%
Mississippi$1,172$3,31654126-2.6%
Montana$1,150$3,8113877-4.4%
South Carolina$1,125$4,72697195-6.5%
North Carolina$1,120$3,641154279-6.9%
Arizona$1,107$3,639113232-8.0%
Iowa$1,095$3,73561137-9.0%
Indiana$1,094$3,407126256-9.0%
Oregon$1,089$3,768101202-9.5%
Kansas$1,085$3,21275187-9.8%
Vermont$1,084$5,4331417-9.9%
Alabama$1,063$2,83591192-11.7%
Colorado$1,060$3,50992164-11.9%
North Dakota$1,059$4,0422036-12.0%
New Hampshire$1,055$5,1933255-12.3%
Delaware$1,053$3,3021660-12.4%
Wisconsin$1,051$8,181108174-12.6%
Wyoming$1,048$4,7631229-12.9%
Rhode Island$1,046$3,7141316-13.1%
West Virginia$1,029$3,5014785-14.4%
Washington$1,028$4,028106229-14.5%
Utah$1,001$2,90855120-16.8%
Nebraska$1,001$3,80752156-16.8%
Minnesota$998$4,836102173-17.0%
Idaho$975$3,9864786-19.0%
Maine$917$3,0043874-23.8%
South Dakota$915$3,54440124-23.9%

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

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