00752

Anesthesia for procedure to repair upper abdominal incisional hernia and/or wound opening

Medicare pricing data for 19,870 providers across 52 states

🤖AI Overview

This procedure has a 10.1x markup — hospitals charge $2,137 but Medicare allows only $212.57. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. Prices vary significantly by location — from $156 in Mississippi to $372 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 procedure to repair upper abdominal incisional hernia and/or wound opening (HCPCS code 00752) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $212.57, but hospitals typically charge $2,137 — a 10.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$42.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $212.57, your out-of-pocket cost would be approximately $42.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$212.57
Average Hospital Charge
$2,137
Markup Ratio
10.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,137.20
Medicare Allowed$212.57
Medicare Payment$166.61

Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $166.61 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$372$2,5193345+75.2%
California$295$2,3081,2571,897+38.7%
Montana$290$1,6396891+36.2%
Hawaii$284$1,8052528+33.8%
New Mexico$272$2,36680113+28.1%
Washington$266$1,957408535+25.0%
Utah$262$1,653138183+23.3%
Arkansas$259$1,382192292+21.7%
Oregon$258$1,696152209+21.3%
Nevada$255$2,927133192+19.8%
Idaho$254$1,74893122+19.3%
Maryland$248$2,103407671+16.7%
Oklahoma$242$2,201225361+14.0%
Wyoming$241$2,7172034+13.2%
District of Columbia$239$1,91194137+12.4%
Arizona$239$2,998343473+12.3%
New York$238$2,9311,1071,688+11.8%
Puerto Rico$235$2,1471927+10.5%
Indiana$234$1,811451632+10.1%
Colorado$228$2,209342462+7.2%
Kansas$225$1,521263444+5.7%
Iowa$224$1,518166245+5.4%
New Jersey$224$2,677450621+5.4%
Louisiana$220$1,687325471+3.4%
Delaware$212$2,27389136-0.2%
Illinois$211$2,545675931-0.6%
Nebraska$211$1,272142228-0.9%
New Hampshire$209$2,28484116-1.5%
Texas$209$2,7251,6422,435-1.6%
Connecticut$209$2,454203306-1.6%
Florida$208$2,2241,3251,927-2.0%
Tennessee$206$2,019616956-3.3%
Wisconsin$204$3,046431585-4.1%
Massachusetts$203$1,620613940-4.4%
Missouri$203$1,635482664-4.7%
Kentucky$200$1,836203272-5.7%
Ohio$200$1,6318891,235-5.7%
Minnesota$196$1,872318422-7.7%
Rhode Island$187$1,8613445-12.2%
Maine$187$2,26585106-12.2%
North Dakota$185$1,58686125-12.9%
Michigan$184$2,488527700-13.5%
Virginia$181$2,0446981,119-14.7%
Pennsylvania$179$1,6671,1441,648-15.6%
South Carolina$168$2,174463740-21.0%
Vermont$167$1,0153964-21.3%
Georgia$167$1,721646924-21.5%
West Virginia$167$1,555157215-21.6%
North Carolina$166$2,0767661,183-21.9%
Alabama$165$1,731351535-22.6%
South Dakota$164$1,936108175-23.0%
Mississippi$156$1,218169265-26.6%

⚠️ 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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