70486

Ct scan of face without contrast

Medicare pricing data for 31,586 providers across 52 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $370.04 but Medicare allows only $63.04. Uninsured patients may face bills 5.9 times higher than what insurance negotiates. 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

Ct scan of face without contrast (HCPCS code 70486) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $63.04, but hospitals typically charge $370.04 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.61

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $63.04, your out-of-pocket cost would be approximately $12.61. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$63.04
Average Hospital Charge
$370.04
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$370.04
Medicare Allowed$63.04
Medicare Payment$47.58

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $47.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$80$702931,192+26.4%
Florida$78$4312,25944,924+23.3%
District of Columbia$77$383941,901+21.5%
Arizona$75$48251011,663+18.6%
Nevada$75$5172824,039+18.3%
Maryland$75$35861613,007+18.2%
California$75$4132,79745,435+18.2%
New Jersey$73$43476013,241+15.8%
Montana$72$3071161,676+13.9%
Kansas$70$2963536,981+11.0%
Wyoming$70$48761838+10.8%
Texas$69$4782,23041,669+10.1%
Georgia$69$42894115,313+8.8%
Utah$68$2832733,730+8.3%
New York$68$3961,54430,050+8.1%
Mississippi$68$4422836,542+7.5%
Puerto Rico$67$142114512+6.8%
South Carolina$67$42462511,140+6.0%
Colorado$63$35255010,091-0.6%
Alabama$61$2365419,613-3.3%
Tennessee$60$37691113,714-4.5%
Washington$60$2917068,861-4.7%
Illinois$60$3591,29821,846-5.2%
Oregon$59$3004284,898-5.9%
North Carolina$58$3601,21017,248-7.3%
Louisiana$58$3184747,404-7.6%
New Mexico$57$3221721,927-9.6%
Rhode Island$56$2931311,902-10.8%
Connecticut$56$3204515,625-11.3%
Indiana$55$3346019,493-12.5%
Virginia$54$34179513,872-13.7%
Hawaii$54$2561191,229-13.9%
Minnesota$54$3231,13016,001-14.5%
North Dakota$53$262991,127-15.3%
Wisconsin$53$5207608,195-16.5%
Missouri$53$28670212,178-16.6%
Maine$52$2481111,629-16.8%
Oklahoma$52$3043225,745-17.2%
Delaware$52$255831,797-17.7%
Iowa$52$3613154,430-18.2%
Nebraska$52$2462414,394-18.3%
Kentucky$51$2633645,445-19.0%
Idaho$50$2601783,565-20.7%
Massachusetts$49$26083212,366-21.7%
Pennsylvania$49$2941,38920,114-21.8%
Arkansas$48$2373174,689-24.0%
New Hampshire$47$4491782,167-25.3%
Michigan$45$24676311,746-28.1%
South Dakota$45$191113989-28.3%
Ohio$45$3041,10614,616-28.5%
West Virginia$42$2611782,580-32.9%
Vermont$41$25535704-34.8%

⚠️ 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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