A4562

Pessary, non rubber, any type

Medicare pricing data for 6,717 providers across 50 states

🤖AI Overview

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

Pessary, non rubber, any type (HCPCS code A4562) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $64.64, but hospitals typically charge $116.91 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.93

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $64.64, your out-of-pocket cost would be approximately $12.93. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$64.64
Average Hospital Charge
$116.91
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$116.91
Medicare Allowed$64.64
Medicare Payment$48.32

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $48.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
North Dakota$67$115933+4.3%
South Dakota$67$902038+3.7%
Colorado$67$112118507+3.5%
Kentucky$67$13290640+3.2%
Montana$67$8935154+3.2%
Wisconsin$67$119116360+3.0%
Tennessee$67$1241781,061+3.0%
Oklahoma$67$11164468+2.9%
Florida$66$1334432,910+2.8%
Nebraska$66$10760323+2.6%
Texas$66$1273402,129+2.6%
Minnesota$66$112130680+2.5%
Missouri$66$10296494+2.3%
Kansas$66$8766550+2.2%
Alabama$66$9666303+2.2%
Mississippi$66$9773349+2.1%
North Carolina$66$1183051,938+2.0%
Iowa$66$11187618+1.7%
Louisiana$66$9770390+1.7%
Indiana$66$1011971,176+1.7%
Michigan$66$101217688+1.7%
Illinois$66$1132891,842+1.5%
Arkansas$66$10570331+1.3%
Wyoming$65$86818+1.1%
Georgia$65$1431771,017+0.9%
Ohio$65$1052261,199+0.7%
Utah$65$8444136+0.7%
New Mexico$65$10539169+0.4%
Maine$65$1141758+0.0%
Pennsylvania$65$964372,318-0.1%
Washington$65$1131901,135-0.1%
Idaho$64$873079-0.4%
New York$64$1573862,309-0.6%
Oregon$64$105127773-0.6%
New Jersey$64$982281,318-0.7%
Arizona$64$1041141,250-0.8%
Rhode Island$64$11236204-0.9%
California$64$1414763,134-1.2%
Maryland$64$1081581,128-1.4%
Nevada$64$11945147-1.4%
West Virginia$64$843192-1.6%
New Hampshire$64$10257319-1.7%
South Carolina$63$11788506-2.1%
Connecticut$63$7990259-3.0%
Hawaii$63$1241465-3.2%
Massachusetts$61$1352501,785-5.0%
Alaska$61$1072043-5.0%
Delaware$61$9229146-5.1%
District of Columbia$59$8424344-9.4%
Virginia$57$932171,588-11.5%

⚠️ 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