00790

Anesthesia for other procedure on upper abdomen

Medicare pricing data for 71,441 providers across 52 states

🤖AI Overview

This procedure has a 10.0x markup — hospitals charge $2,454 but Medicare allows only $244.81. Uninsured patients may face bills 10.0 times higher than what insurance negotiates. Prices vary significantly by location — from $174 in South Dakota to $442 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 other procedure on upper abdomen (HCPCS code 00790) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $244.81, but hospitals typically charge $2,454 — a 10.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$48.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $244.81, your out-of-pocket cost would be approximately $48.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$244.81
Average Hospital Charge
$2,454
Markup Ratio
10.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,453.57
Medicare Allowed$244.81
Medicare Payment$193.30

Hospitals charge 10.0x more than what Medicare allows for this procedure. Medicare actually pays $193.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$442$2,647127469+80.7%
California$346$2,6174,49622,715+41.2%
Montana$326$1,9012011,218+33.2%
Puerto Rico$325$2,25485363+32.8%
Oregon$322$2,0576943,170+31.5%
Utah$313$1,9544881,879+27.9%
Idaho$311$2,1313001,378+27.0%
Hawaii$307$2,128132593+25.5%
Washington$298$2,1491,3806,691+21.7%
Nevada$295$2,9493862,243+20.7%
New Mexico$293$2,5973221,359+19.7%
Iowa$288$1,9175843,055+17.5%
Wyoming$284$2,26880395+16.0%
Arkansas$283$1,6635853,441+15.8%
Arizona$283$3,0431,2036,738+15.5%
New York$282$3,6093,84119,994+15.3%
Maryland$278$2,5811,1406,876+13.6%
Nebraska$274$1,7625392,887+12.1%
District of Columbia$270$2,3962931,612+10.3%
Indiana$268$2,1961,3326,997+9.7%
New Jersey$268$3,0121,5668,778+9.4%
Delaware$266$2,5702431,622+8.7%
Colorado$259$2,4691,1224,962+5.9%
Massachusetts$259$2,0851,89811,050+5.7%
Oklahoma$257$2,2917174,078+4.8%
Illinois$253$2,9882,62813,812+3.4%
Florida$247$2,7265,16226,070+0.8%
Louisiana$244$1,9191,1335,575-0.5%
Kansas$242$1,5628585,024-1.0%
Rhode Island$241$2,043180871-1.5%
Kentucky$238$2,2021,1725,528-2.7%
Connecticut$237$2,7099054,153-3.0%
Texas$237$2,9375,54427,419-3.1%
New Hampshire$237$3,2643941,891-3.2%
Tennessee$235$2,2782,06110,173-3.9%
Ohio$232$1,9753,25915,127-5.1%
Wisconsin$231$3,3041,5116,844-5.7%
Vermont$226$1,502139808-7.7%
Missouri$221$1,8221,8239,393-9.6%
Virginia$218$2,5251,85411,412-11.0%
Maine$213$2,2094871,955-13.0%
Michigan$209$2,6922,66411,221-14.7%
Pennsylvania$206$2,0934,16620,544-15.8%
North Dakota$202$1,6782821,407-17.6%
Minnesota$201$1,8911,7947,725-18.0%
West Virginia$200$2,1105512,706-18.1%
North Carolina$194$2,3922,67014,095-20.9%
Georgia$187$1,9842,50313,010-23.6%
Mississippi$185$1,3286555,073-24.6%
South Carolina$182$2,4391,4398,950-25.7%
Alabama$175$1,6441,3827,384-28.6%
South Dakota$174$1,9343372,057-28.7%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber