A9587

Gallium ga-68, dotatate, diagnostic, 0.1 millicurie

Medicare pricing data for 715 providers across 32 states

🤖AI Overview

Prices vary significantly by location — from $56 in Alaska to $467 in New Mexico. 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

Gallium ga-68, dotatate, diagnostic, 0.1 millicurie (HCPCS code A9587) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $86.15, but hospitals typically charge $228.31 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.23

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $86.15, your out-of-pocket cost would be approximately $17.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$86.15
Average Hospital Charge
$228.31
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$228.31
Medicare Allowed$86.15
Medicare Payment$68.63

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $68.63 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Mexico$467$1,1183175+441.9%
Louisiana$368$8011178+326.7%
Oklahoma$247$1,0059920+186.9%
Kansas$240$3111229+178.1%
Arkansas$237$1,02781,096+175.6%
New Jersey$225$351231,249+161.0%
Texas$189$5201387,990+118.9%
Pennsylvania$181$306251,397+109.8%
Colorado$161$639263,468+86.5%
Maryland$146$180254,380+69.4%
Virginia$131$242112,699+51.9%
Missouri$129$3003258+49.6%
Wisconsin$106$141142,412+23.0%
Minnesota$90$1505450+4.3%
Illinois$79$147122,017-8.2%
Idaho$77$2755755-10.5%
Iowa$73$12531,435-15.6%
North Carolina$72$20412645-16.3%
New York$72$1516720,546-16.4%
Nebraska$70$13871,721-18.2%
Indiana$64$4687347-25.4%
Oregon$62$1717546-27.6%
California$62$22912023,556-27.7%
Alabama$62$1262212,407-27.9%
Ohio$62$1355702-28.0%
Arizona$61$229337,427-29.2%
Nevada$61$175112,214-29.4%
Florida$60$1504614,558-29.9%
Washington$59$277224,795-31.2%
Hawaii$58$20021,064-33.1%
Massachusetts$57$109206,959-34.0%
Alaska$56$2474518-35.0%

⚠️ 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