52648

Complete laser vaporization of prostate including control of bleeding using an endoscope

Medicare pricing data for 2,288 providers across 51 states

🤖AI Overview

This procedure has a 6.3x markup — hospitals charge $5,845 but Medicare allows only $931.12. Uninsured patients may face bills 6.3 times higher than what insurance negotiates. Prices vary significantly by location — from $630 in Idaho to $1,369 in Maryland. 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

Complete laser vaporization of prostate including control of bleeding using an endoscope (HCPCS code 52648) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $931.12, but hospitals typically charge $5,845 — a 6.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$186.22

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $931.12, your out-of-pocket cost would be approximately $186.22. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$931.12
Average Hospital Charge
$5,845
Markup Ratio
6.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$5,845.31
Medicare Allowed$931.12
Medicare Payment$737.59

Hospitals charge 6.3x more than what Medicare allows for this procedure. Medicare actually pays $737.59 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$1,369$6,267841,192+47.1%
Colorado$1,281$9,64144396+37.6%
Hawaii$1,202$5,041529+29.1%
Mississippi$1,103$4,82420197+18.5%
New York$1,091$7,641135934+17.1%
Delaware$1,085$4,08613157+16.5%
Virginia$1,060$6,22956650+13.9%
Washington$1,032$4,42326151+10.9%
Arizona$1,027$7,26064570+10.3%
Illinois$995$6,9351411,061+6.8%
Indiana$985$8,68543414+5.8%
California$978$7,150155866+5.0%
North Carolina$940$6,55653264+1.0%
Wyoming$919$2,614412-1.3%
Florida$916$5,4032061,299-1.7%
Texas$906$5,339154959-2.7%
New Jersey$888$10,962104570-4.6%
Alaska$888$17,053513-4.7%
Nevada$886$4,382987-4.8%
Tennessee$874$4,24939223-6.1%
Iowa$869$3,74415316-6.7%
Puerto Rico$866$1,3952347-6.9%
South Carolina$832$6,93635235-10.7%
Pennsylvania$830$3,70881439-10.9%
Ohio$812$3,6991141,080-12.8%
Connecticut$798$6,75537113-14.3%
Arkansas$798$2,87624141-14.3%
Missouri$760$4,83442344-18.3%
Oregon$758$4,78725113-18.6%
District of Columbia$751$4,166627-19.4%
Michigan$750$3,04639193-19.5%
Utah$733$2,023439-21.3%
Massachusetts$732$3,52558378-21.4%
Minnesota$719$8,14952217-22.7%
Oklahoma$700$3,01849426-24.9%
Montana$687$2,455539-26.2%
New Hampshire$680$6,55517202-26.9%
New Mexico$679$5,867852-27.1%
Kansas$678$4,15718171-27.2%
West Virginia$667$2,32816107-28.4%
Georgia$667$4,76145349-28.4%
Nebraska$667$4,66018107-28.4%
North Dakota$665$2,034333-28.6%
Louisiana$661$2,88340210-29.0%
Vermont$661$7,036437-29.0%
Maine$659$1,97021105-29.2%
South Dakota$651$969216-30.1%
Kentucky$641$4,52924116-31.2%
Wisconsin$641$10,78134160-31.2%
Alabama$634$2,3771899-31.9%
Idaho$630$1,743735-32.3%

⚠️ 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