00145

Anesthesia for retinal surgery

Medicare pricing data for 20,121 providers across 52 states

🤖AI Overview

This procedure has a 9.5x markup — hospitals charge $1,502 but Medicare allows only $158.71. Uninsured patients may face bills 9.5 times higher than what insurance negotiates. Prices vary significantly by location — from $118 in Alabama to $283 in Alaska. 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

Anesthesia for retinal surgery (HCPCS code 00145) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $158.71, but hospitals typically charge $1,502 — a 9.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$31.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $158.71, your out-of-pocket cost would be approximately $31.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$158.71
Average Hospital Charge
$1,502
Markup Ratio
9.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,501.78
Medicare Allowed$158.71
Medicare Payment$124.87

Hospitals charge 9.5x more than what Medicare allows for this procedure. Medicare actually pays $124.87 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$283$1,3241237+78.5%
Puerto Rico$274$4441865+72.7%
Wyoming$225$1,3201947+41.8%
California$207$1,5451,7988,818+30.3%
Iowa$205$1,1642041,194+29.1%
Hawaii$202$1,31248235+27.0%
Nevada$200$1,685141790+26.3%
Washington$200$1,2393872,175+26.3%
Oregon$200$1,1142221,338+26.0%
Montana$197$97160394+23.9%
Delaware$196$1,49971322+23.7%
Maine$189$1,42654310+19.2%
Maryland$187$1,6373742,340+18.1%
New Jersey$184$2,2764162,721+15.9%
Utah$180$1,0271781,168+13.7%
Arkansas$179$1,096145926+12.7%
Idaho$178$1,07079514+12.1%
Vermont$177$1,03456203+11.8%
Oklahoma$177$1,1371741,557+11.5%
New York$176$2,2491,0075,859+11.2%
Arizona$176$1,9932143,052+10.9%
Louisiana$175$1,2233271,450+10.0%
Kentucky$174$1,2172681,385+9.8%
New Mexico$174$1,48255333+9.4%
New Hampshire$171$2,073101358+7.9%
Indiana$169$1,4203582,533+6.3%
South Dakota$166$68558712+4.6%
Illinois$165$1,7041,0153,989+3.8%
Nebraska$164$998155979+3.5%
Florida$164$1,7021,3178,146+3.5%
Kansas$160$9322761,756+0.8%
District of Columbia$159$1,51272434-0.1%
Missouri$156$1,1254882,746-1.6%
Connecticut$156$1,6692631,046-1.8%
Colorado$156$1,5273122,070-2.0%
Massachusetts$151$1,1834553,378-4.7%
Tennessee$148$1,3235463,773-6.7%
Texas$144$1,8521,58110,340-9.0%
Ohio$144$1,0136904,563-9.3%
Michigan$140$1,9058143,612-11.8%
Virginia$140$1,3675303,479-12.1%
Mississippi$137$9461811,198-13.8%
Wisconsin$136$2,0825392,275-14.6%
West Virginia$131$822105820-17.5%
South Carolina$130$1,3634133,008-17.9%
Minnesota$130$1,0705032,888-18.2%
Pennsylvania$129$1,2511,0286,599-18.7%
North Carolina$128$1,6288784,444-19.4%
Georgia$128$1,2775922,970-19.5%
Rhode Island$127$78865312-20.0%
North Dakota$124$1,06093520-22.0%
Alabama$118$1,2463052,661-25.7%

⚠️ 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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