00918

Anesthesia for fragmenting, manipulation and/or removal of kidney stone including use of an endoscope

Medicare pricing data for 48,017 providers across 52 states

🤖AI Overview

This procedure has a 10.4x markup — hospitals charge $1,504 but Medicare allows only $144.23. Uninsured patients may face bills 10.4 times higher than what insurance negotiates. Prices vary significantly by location — from $106 in South Dakota to $286 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 fragmenting, manipulation and/or removal of kidney stone including use of an endoscope (HCPCS code 00918) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $144.23, but hospitals typically charge $1,504 — a 10.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $144.23, your out-of-pocket cost would be approximately $28.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$144.23
Average Hospital Charge
$1,504
Markup Ratio
10.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,503.92
Medicare Allowed$144.23
Medicare Payment$113.66

Hospitals charge 10.4x more than what Medicare allows for this procedure. Medicare actually pays $113.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$286$1,73395246+98.2%
California$217$1,6762,6556,734+50.7%
Puerto Rico$204$1,8514193+41.5%
Montana$199$1,133157459+37.9%
Hawaii$193$1,30096270+34.0%
Utah$193$1,198354897+33.9%
Idaho$191$1,255176558+32.4%
Washington$191$1,3589262,568+32.4%
Oregon$190$1,2564471,268+31.7%
Wyoming$189$1,46753237+30.7%
Nevada$181$1,773246638+25.3%
New Mexico$176$1,592195496+21.9%
Arkansas$171$1,0963811,067+18.7%
Arizona$171$1,8938392,457+18.5%
Oklahoma$170$1,4285041,582+17.6%
Iowa$170$1,1234221,621+17.5%
Maryland$169$1,6316462,580+17.3%
Nebraska$168$1,0973771,201+16.5%
New York$165$2,1132,4757,559+14.6%
Colorado$158$1,5807091,848+9.3%
District of Columbia$155$1,622179562+7.3%
New Jersey$155$1,8201,1784,040+7.3%
Indiana$154$1,2769993,379+6.8%
Florida$153$1,7353,45410,270+6.4%
Louisiana$153$1,2987031,998+6.0%
Kansas$152$9525591,992+5.4%
Illinois$152$1,8721,9226,003+5.1%
Kentucky$145$1,4308022,406+0.6%
Vermont$144$890106359+0.1%
Delaware$144$1,434159641-0.1%
Rhode Island$143$1,425145539-1.1%
Texas$142$1,9613,3009,006-1.5%
New Hampshire$138$1,8902941,073-4.2%
Tennessee$136$1,3551,3324,541-5.9%
Ohio$135$1,2002,2596,783-6.1%
Massachusetts$134$1,1621,4095,001-6.8%
Mississippi$134$1,0174141,608-7.2%
Connecticut$132$1,7266772,076-8.1%
Wisconsin$132$1,9641,0703,065-8.6%
Missouri$130$1,0671,1883,627-9.7%
Maine$122$1,312359978-15.3%
Virginia$122$1,2471,2135,078-15.7%
West Virginia$120$1,2323421,106-16.6%
Pennsylvania$118$1,3222,9929,941-18.0%
Minnesota$118$1,1151,2203,244-18.3%
Michigan$118$1,6471,9576,085-18.4%
North Dakota$118$1,016195680-18.5%
Georgia$118$1,1921,6335,159-18.5%
North Carolina$114$1,4951,8936,128-20.6%
South Carolina$111$1,5351,0344,237-23.0%
Alabama$110$1,1329102,703-23.6%
South Dakota$106$1,147257956-26.6%

⚠️ 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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