00912

Anesthesia for removal of urinary bladder tumors including use of an endoscope

Medicare pricing data for 42,337 providers across 52 states

🤖AI Overview

This procedure has a 10.3x markup — hospitals charge $1,426 but Medicare allows only $138.70. Uninsured patients may face bills 10.3 times higher than what insurance negotiates. Prices vary significantly by location — from $101 in South Dakota 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 removal of urinary bladder tumors including use of an endoscope (HCPCS code 00912) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $138.70, but hospitals typically charge $1,426 — a 10.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $138.70, your out-of-pocket cost would be approximately $27.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$138.70
Average Hospital Charge
$1,426
Markup Ratio
10.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,425.52
Medicare Allowed$138.70
Medicare Payment$109.18

Hospitals charge 10.3x more than what Medicare allows for this procedure. Medicare actually pays $109.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$253$1,52769148+82.4%
Puerto Rico$206$2,0404058+48.5%
California$194$1,5202,7046,759+39.6%
Utah$188$1,182234440+35.5%
Wyoming$184$1,59446138+32.4%
Montana$181$1,100133301+30.8%
Idaho$179$1,166149358+28.7%
Oregon$173$1,132343842+24.7%
Nevada$172$1,777235534+24.2%
Washington$169$1,2428842,079+22.2%
Hawaii$169$1,22376178+21.7%
Arkansas$168$1,010324825+21.2%
New Mexico$166$1,469148280+20.0%
Iowa$166$1,132376930+20.0%
Maryland$161$1,5255892,152+15.8%
Arizona$159$1,9767892,209+14.8%
Nebraska$158$1,036290636+13.7%
Oklahoma$157$1,285412982+13.0%
New York$151$1,8722,5227,320+8.7%
Indiana$149$1,2228252,011+7.7%
New Jersey$146$1,7021,1413,092+5.4%
Florida$145$1,5773,1278,099+4.3%
Louisiana$145$1,1055601,252+4.2%
Colorado$144$1,5186101,267+3.9%
Illinois$143$1,6981,6984,343+2.9%
District of Columbia$142$1,416175463+2.5%
Kansas$142$8744851,286+2.2%
Kentucky$140$1,3526281,305+1.3%
Delaware$140$1,294165520+0.8%
Massachusetts$133$1,0931,3113,979-4.2%
Tennessee$133$1,3261,0842,682-4.4%
Rhode Island$132$1,317122365-4.9%
Texas$132$1,7282,8416,460-5.2%
Ohio$130$1,1251,8904,226-6.3%
Mississippi$129$1,014328829-7.0%
Missouri$129$1,0211,0312,389-7.2%
New Hampshire$129$1,822259815-7.3%
Wisconsin$123$1,8609221,851-11.0%
Connecticut$123$1,5906411,749-11.0%
Vermont$120$80282194-13.4%
Minnesota$120$1,0921,0132,082-13.8%
North Dakota$117$972180420-15.5%
Virginia$117$1,2971,1233,544-15.9%
West Virginia$116$1,163282661-16.0%
Michigan$116$1,5881,6333,666-16.2%
Maine$116$1,177299683-16.3%
Pennsylvania$115$1,1882,5596,534-17.3%
North Carolina$112$1,4211,6513,881-19.0%
Georgia$112$1,1351,4573,504-19.1%
South Carolina$110$1,4468522,620-20.7%
Alabama$103$1,0597291,561-25.4%
South Dakota$101$1,086211517-27.1%

⚠️ 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