00873

Anesthesia for shock wave therapy for urinary system stones without water bath

Medicare pricing data for 17,553 providers across 52 states

🤖AI Overview

This procedure has a 10.0x markup — hospitals charge $1,404 but Medicare allows only $140.21. Uninsured patients may face bills 10.0 times higher than what insurance negotiates. Prices vary significantly by location — from $100 in Pennsylvania to $253 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 shock wave therapy for urinary system stones without water bath (HCPCS code 00873) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $140.21, but hospitals typically charge $1,404 — a 10.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.04

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $140.21, your out-of-pocket cost would be approximately $28.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$140.21
Average Hospital Charge
$1,404
Markup Ratio
10.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,404.42
Medicare Allowed$140.21
Medicare Payment$110.28

Hospitals charge 10.0x more than what Medicare allows for this procedure. Medicare actually pays $110.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$253$1,5141931+80.5%
Puerto Rico$229$9272353+63.0%
California$204$1,5771,1032,499+45.3%
Montana$199$1,14675137+41.6%
Hawaii$195$1,3321945+38.9%
Wyoming$188$1,3962349+34.2%
Utah$187$1,039147398+33.3%
Nebraska$183$1,001147391+30.5%
Washington$179$1,329328725+27.4%
Arizona$178$2,4325601,635+27.3%
Kansas$177$1,032136349+26.6%
Oregon$177$1,151111170+26.3%
Arkansas$177$912206561+26.0%
Colorado$177$1,522181436+26.0%
Idaho$177$1,14784167+25.9%
Nevada$174$1,887124259+23.8%
Oklahoma$163$1,233242852+16.1%
New Jersey$161$1,7133801,718+14.8%
Delaware$160$1,34486462+13.8%
Maryland$158$1,719156746+12.8%
New Mexico$156$1,31566114+11.3%
Iowa$154$1,062176469+9.8%
Louisiana$151$982313756+7.5%
Indiana$148$1,1774351,132+5.5%
Florida$148$1,5541,3983,190+5.3%
North Dakota$146$1,1473664+4.4%
New York$146$2,3307961,905+3.9%
Illinois$144$1,5966671,814+2.4%
Wisconsin$142$1,863253419+1.0%
Tennessee$140$1,2656351,468-0.3%
Kentucky$139$1,0273871,172-1.2%
Missouri$137$1,2274291,124-2.0%
Ohio$135$1,1599142,231-3.8%
Texas$134$1,8861,4693,260-4.6%
District of Columbia$133$1,8132050-5.5%
Maine$131$1,2715490-6.8%
Mississippi$122$8733431,561-12.9%
Vermont$122$9231834-13.2%
South Dakota$121$1,12186150-14.0%
Georgia$117$1,1336871,832-16.4%
New Hampshire$115$1,46779175-17.8%
North Carolina$113$1,378338809-19.1%
Minnesota$112$1,097227343-19.8%
Rhode Island$109$89342128-22.0%
Connecticut$107$1,215241565-23.8%
South Carolina$107$1,1334001,576-24.0%
West Virginia$106$1,133172452-24.7%
Virginia$103$1,0863331,091-26.3%
Michigan$103$1,4816001,268-26.3%
Massachusetts$103$1,1294721,623-26.7%
Alabama$101$9204711,435-28.0%
Pennsylvania$100$1,1087861,797-28.8%

⚠️ 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