P9612

Catheterization for collection of specimen, single patient, all places of service

Medicare pricing data for 1,766 providers across 42 states

🤖AI Overview

Prices vary significantly by location — from $4 in Nebraska to $8 in Michigan. 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

Catheterization for collection of specimen, single patient, all places of service (HCPCS code P9612) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.54, but hospitals typically charge $28.65 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.54, your out-of-pocket cost would be approximately $1.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.54
Average Hospital Charge
$28.65
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$28.65
Medicare Allowed$7.54
Medicare Payment$7.54

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $7.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Michigan$8$28926+11.4%
Mississippi$8$10171,090+10.9%
Massachusetts$8$2416480+10.7%
Alabama$8$1446638+9.0%
New York$8$101191,583+8.1%
Virginia$8$141371,647+8.1%
Idaho$8$1271568+7.0%
Wisconsin$8$1762036+6.8%
New Mexico$8$16535+6.6%
District of Columbia$8$12734+6.5%
Kansas$8$551436+5.8%
Minnesota$8$7947102+5.8%
Pennsylvania$8$2160393+5.4%
South Carolina$8$914200+4.8%
Arizona$8$100108759+4.1%
California$8$4265354+3.8%
Indiana$8$143482+3.6%
Texas$8$151581,544+3.1%
Florida$8$1101181,235+2.1%
Georgia$8$7760533+1.9%
Missouri$8$512363+1.1%
Illinois$8$8436355+0.1%
Oklahoma$7$10262,603-0.8%
Iowa$7$1624145-1.7%
South Dakota$7$91837-3.1%
Louisiana$7$1220225-4.6%
Tennessee$7$2559748-4.9%
Colorado$7$984317-9.7%
Maryland$7$1354294-10.5%
Oregon$6$161737-13.9%
Ohio$6$959232-14.3%
Nevada$6$1010112-16.0%
New Jersey$6$2423140-16.7%
Delaware$6$11457-16.8%
Arkansas$6$121674-17.0%
Kentucky$6$71895-18.8%
Washington$6$968278-21.0%
Connecticut$6$61237-23.2%
North Carolina$5$878704-30.8%
Wyoming$4$181126-40.5%
Puerto Rico$4$910270-40.6%
Nebraska$4$41230-51.3%

⚠️ 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