91122

Study of rectum sensitivity and function

Medicare pricing data for 1,534 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $85 in North Dakota to $289 in New York. 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

Study of rectum sensitivity and function (HCPCS code 91122) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $206.92, but hospitals typically charge $684.59 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$41.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $206.92, your out-of-pocket cost would be approximately $41.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$206.92
Average Hospital Charge
$684.59
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$684.59
Medicare Allowed$206.92
Medicare Payment$162.45

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $162.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$289$8271341,565+39.6%
Delaware$276$502232+33.3%
New Jersey$272$84129323+31.5%
Maine$269$5574271+29.9%
Nevada$259$76118225+25.1%
Arizona$249$70929603+20.4%
Florida$245$6591872,025+18.5%
Oklahoma$244$602458+18.1%
Vermont$239$825211+15.7%
Oregon$237$6841089+14.6%
Maryland$228$55345336+10.1%
Rhode Island$226$445561+9.1%
Utah$222$35911136+7.2%
Virginia$220$53947473+6.4%
Texas$216$5541321,570+4.6%
Arkansas$211$4815101+2.0%
West Virginia$205$548583-0.8%
Kentucky$203$5561382-1.7%
Colorado$202$51219269-2.2%
California$201$1,2661191,998-2.9%
Alabama$198$32828231-4.3%
District of Columbia$198$339569-4.5%
Minnesota$196$853421,213-5.2%
Georgia$193$54762645-6.5%
Nebraska$193$56617161-6.7%
Illinois$185$68355788-10.5%
Tennessee$184$52928229-11.0%
Louisiana$182$58116178-11.9%
Hawaii$179$328326-13.4%
Kansas$175$49414136-15.6%
Michigan$172$50530240-16.9%
Indiana$171$45925161-17.5%
North Carolina$169$45848474-18.3%
Missouri$167$47620277-19.1%
Pennsylvania$165$48069537-20.4%
Massachusetts$152$52345469-26.6%
South Carolina$144$4231761-30.6%
Ohio$140$467731,057-32.5%
New Hampshire$138$6682109-33.2%
Connecticut$133$55120168-35.6%
Mississippi$131$3459149-36.8%
Iowa$122$516989-41.0%
Wisconsin$121$90933194-41.7%
Washington$117$39415122-43.5%
Alaska$117$1,017118-43.6%
South Dakota$114$184660-44.7%
New Mexico$104$307319-49.9%
North Dakota$85$254323-58.8%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber