52441

Insertion of implant in urethra within prostate gland using an endoscope, 1 implant

Medicare pricing data for 3,073 providers across 51 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $2,620 but Medicare allows only $495.29. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Prices vary significantly by location — from $180 in Arkansas to $1,375 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

Insertion of implant in urethra within prostate gland using an endoscope, 1 implant (HCPCS code 52441) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $495.29, but hospitals typically charge $2,620 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$99.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $495.29, your out-of-pocket cost would be approximately $99.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$495.29
Average Hospital Charge
$2,620
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,620.49
Medicare Allowed$495.29
Medicare Payment$391.04

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $391.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,375$5,695227+177.6%
California$911$3,0342861,726+83.9%
New Jersey$864$6,202126766+74.4%
Nevada$777$3,1812285+56.9%
New York$766$3,723191763+54.6%
Connecticut$738$3,1392293+49.0%
Iowa$734$2,93643230+48.2%
Illinois$717$3,58399635+44.8%
Utah$703$2,4511697+42.0%
Texas$648$2,2971991,188+30.8%
Oregon$641$3,24736224+29.5%
Arizona$625$2,711127880+26.3%
New Hampshire$604$1,78813108+21.9%
Wisconsin$603$6,94846187+21.8%
North Carolina$586$2,55296545+18.3%
Michigan$586$1,84098469+18.3%
Minnesota$552$4,1882872+11.4%
Washington$543$1,84155561+9.7%
Louisiana$505$2,91749302+2.0%
Delaware$475$1,2631582-4.0%
Indiana$463$2,98271462-6.5%
Colorado$450$3,19745386-9.1%
Tennessee$439$2,377106672-11.3%
Massachusetts$432$2,38756223-12.7%
Nebraska$361$1,38132267-27.2%
South Carolina$333$2,12862544-32.8%
Kansas$313$2,12535215-36.9%
Georgia$309$1,877120812-37.7%
Florida$307$1,7832511,819-37.9%
Ohio$305$1,815130731-38.4%
Missouri$283$2,08168341-42.9%
Oklahoma$274$94031258-44.8%
Kentucky$263$1,31640213-47.0%
Virginia$248$1,39253536-49.9%
Pennsylvania$234$1,772130843-52.7%
Mississippi$218$2,62339452-56.1%
Maryland$217$4,44979765-56.2%
District of Columbia$215$2,442443-56.6%
Rhode Island$207$1,491513-58.3%
New Mexico$203$2,332619-59.0%
Montana$203$6531173-59.1%
Wyoming$200$1,897536-59.7%
North Dakota$199$2,306431-59.7%
Hawaii$197$1,311855-60.1%
Alabama$191$93631138-61.4%
South Dakota$188$2,464948-62.0%
Maine$188$459419-62.0%
West Virginia$187$1,4261359-62.3%
Idaho$186$93417110-62.4%
Vermont$184$2,561454-62.9%
Arkansas$180$2,48321105-63.6%

⚠️ 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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