Biopsy of bladder using an endoscope
Medicare pricing data for 7,017 providers across 51 states
This procedure has a 7.0x markup — hospitals charge $1,778 but Medicare allows only $253.66. Uninsured patients may face bills 7.0 times higher than what insurance negotiates. Prices vary significantly by location — from $106 in Vermont to $433 in Alaska. 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
Biopsy of bladder using an endoscope (HCPCS code 52204) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $253.66, but hospitals typically charge $1,778 — a 7.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $253.66, your out-of-pocket cost would be approximately $50.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $198.37 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $433 | $6,845 | 18 | 44 | +70.7% |
| Maryland | $374 | $2,228 | 156 | 841 | +47.3% |
| Delaware | $371 | $1,657 | 25 | 160 | +46.4% |
| Mississippi | $369 | $1,622 | 64 | 738 | +45.4% |
| New Jersey | $345 | $3,562 | 255 | 1,039 | +36.2% |
| Colorado | $308 | $2,472 | 122 | 383 | +21.2% |
| Virginia | $297 | $1,750 | 181 | 842 | +17.0% |
| California | $296 | $1,963 | 588 | 1,876 | +16.5% |
| Florida | $293 | $2,200 | 540 | 3,035 | +15.5% |
| Georgia | $284 | $1,525 | 217 | 878 | +12.1% |
| Kansas | $273 | $1,772 | 74 | 289 | +7.7% |
| Arizona | $272 | $1,894 | 158 | 594 | +7.2% |
| South Carolina | $271 | $1,495 | 144 | 727 | +6.9% |
| New York | $259 | $1,759 | 461 | 1,560 | +2.3% |
| Oregon | $249 | $1,206 | 89 | 230 | -2.0% |
| Texas | $242 | $1,944 | 450 | 1,264 | -4.4% |
| Tennessee | $241 | $1,428 | 203 | 969 | -4.9% |
| Idaho | $240 | $898 | 29 | 97 | -5.2% |
| Rhode Island | $240 | $887 | 22 | 80 | -5.4% |
| Missouri | $236 | $1,606 | 141 | 535 | -6.9% |
| Wyoming | $234 | $2,708 | 13 | 44 | -7.9% |
| Washington | $233 | $851 | 153 | 545 | -8.0% |
| Indiana | $224 | $2,714 | 163 | 607 | -11.5% |
| Kentucky | $224 | $2,015 | 58 | 190 | -11.7% |
| Pennsylvania | $221 | $1,436 | 339 | 1,505 | -12.7% |
| Illinois | $221 | $1,713 | 296 | 1,300 | -12.8% |
| Iowa | $221 | $1,715 | 74 | 305 | -13.0% |
| Ohio | $218 | $1,208 | 284 | 965 | -13.9% |
| Minnesota | $217 | $1,797 | 141 | 367 | -14.5% |
| Arkansas | $209 | $736 | 48 | 216 | -17.5% |
| Massachusetts | $196 | $1,632 | 203 | 756 | -22.8% |
| District of Columbia | $193 | $1,098 | 26 | 98 | -23.8% |
| Connecticut | $190 | $1,841 | 87 | 266 | -25.0% |
| Michigan | $188 | $1,072 | 193 | 576 | -26.0% |
| Utah | $179 | $986 | 41 | 107 | -29.3% |
| New Hampshire | $178 | $1,217 | 51 | 172 | -29.7% |
| Nevada | $174 | $1,401 | 35 | 93 | -31.3% |
| Nebraska | $174 | $1,198 | 40 | 168 | -31.3% |
| North Carolina | $173 | $1,505 | 236 | 684 | -31.6% |
| Wisconsin | $173 | $2,352 | 122 | 366 | -31.8% |
| Alabama | $172 | $972 | 78 | 222 | -32.2% |
| New Mexico | $159 | $1,594 | 17 | 32 | -37.3% |
| Hawaii | $155 | $1,338 | 9 | 17 | -38.7% |
| Montana | $144 | $547 | 28 | 103 | -43.4% |
| Louisiana | $138 | $1,101 | 104 | 271 | -45.5% |
| Oklahoma | $134 | $896 | 80 | 269 | -47.3% |
| Maine | $121 | $670 | 34 | 78 | -52.3% |
| North Dakota | $120 | $1,096 | 9 | 16 | -52.7% |
| South Dakota | $115 | $1,289 | 21 | 139 | -54.7% |
| West Virginia | $111 | $646 | 38 | 171 | -56.2% |
| Vermont | $106 | $1,465 | 20 | 70 | -58.0% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber