Test for tone and sensation of rectum and anus
Medicare pricing data for 751 providers across 46 states
Prices vary significantly by location — from $46 in South Carolina to $603 in Washington. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Test for tone and sensation of rectum and anus (HCPCS code 91120) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $452.19, but hospitals typically charge $1,258 — a 2.8x 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 $452.19, your out-of-pocket cost would be approximately $90.44. 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 2.8x more than what Medicare allows for this procedure. Medicare actually pays $355.49 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Washington | $603 | $1,692 | 6 | 37 | +33.3% |
| New York | $578 | $1,489 | 72 | 747 | +27.8% |
| Massachusetts | $555 | $1,787 | 27 | 207 | +22.8% |
| Hawaii | $552 | $911 | 1 | 13 | +22.0% |
| Oregon | $539 | $1,648 | 9 | 54 | +19.1% |
| Colorado | $533 | $1,168 | 13 | 148 | +17.9% |
| Rhode Island | $531 | $918 | 4 | 44 | +17.4% |
| Maryland | $529 | $1,241 | 34 | 187 | +17.0% |
| New Jersey | $526 | $1,198 | 13 | 232 | +16.2% |
| Delaware | $514 | $771 | 2 | 31 | +13.8% |
| Minnesota | $512 | $1,975 | 17 | 408 | +13.2% |
| Virginia | $512 | $989 | 16 | 214 | +13.2% |
| Maine | $491 | $933 | 2 | 175 | +8.6% |
| Nevada | $478 | $1,366 | 14 | 93 | +5.7% |
| Kansas | $467 | $1,421 | 4 | 24 | +3.3% |
| Arizona | $467 | $1,022 | 20 | 236 | +3.3% |
| Iowa | $466 | $1,141 | 4 | 14 | +3.0% |
| North Carolina | $466 | $831 | 24 | 192 | +3.0% |
| Indiana | $465 | $1,101 | 9 | 68 | +2.9% |
| Missouri | $462 | $1,299 | 12 | 119 | +2.3% |
| Texas | $460 | $1,217 | 67 | 471 | +1.6% |
| Oklahoma | $456 | $1,153 | 2 | 48 | +0.9% |
| Alabama | $448 | $578 | 12 | 136 | -1.0% |
| Wisconsin | $447 | $2,101 | 11 | 39 | -1.1% |
| Georgia | $445 | $1,222 | 26 | 225 | -1.7% |
| Florida | $443 | $1,115 | 105 | 995 | -1.9% |
| Pennsylvania | $441 | $943 | 25 | 147 | -2.5% |
| Nebraska | $438 | $1,297 | 10 | 70 | -3.1% |
| Illinois | $438 | $1,066 | 24 | 204 | -3.2% |
| Arkansas | $432 | $999 | 2 | 98 | -4.5% |
| Tennessee | $426 | $1,138 | 14 | 135 | -5.8% |
| Utah | $394 | $603 | 11 | 137 | -12.9% |
| Kentucky | $384 | $1,065 | 6 | 24 | -15.1% |
| Michigan | $373 | $687 | 17 | 155 | -17.6% |
| West Virginia | $364 | $957 | 1 | 49 | -19.4% |
| California | $345 | $2,125 | 44 | 660 | -23.7% |
| Louisiana | $340 | $1,189 | 6 | 134 | -24.9% |
| Connecticut | $296 | $693 | 8 | 46 | -34.4% |
| Ohio | $285 | $804 | 39 | 407 | -37.0% |
| Mississippi | $213 | $376 | 4 | 76 | -53.0% |
| District of Columbia | $53 | $151 | 1 | 30 | -88.4% |
| New Hampshire | $48 | $241 | 1 | 77 | -89.4% |
| North Dakota | $47 | $139 | 3 | 20 | -89.6% |
| New Mexico | $47 | $336 | 1 | 17 | -89.7% |
| South Dakota | $46 | $82 | 2 | 47 | -89.9% |
| South Carolina | $46 | $133 | 2 | 18 | -89.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber