00942

Anesthesia for repair or removal of vagina and urinary procedure

Medicare pricing data for 13,429 providers across 51 states

🤖AI Overview

This procedure has a 10.1x markup — hospitals charge $1,696 but Medicare allows only $168.12. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. Prices vary significantly by location — from $109 in South Dakota to $320 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 repair or removal of vagina and urinary procedure (HCPCS code 00942) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $168.12, but hospitals typically charge $1,696 — a 10.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$33.62

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $168.12, your out-of-pocket cost would be approximately $33.62. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$168.12
Average Hospital Charge
$1,696
Markup Ratio
10.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,695.78
Medicare Allowed$168.12
Medicare Payment$131.82

Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $131.82 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$320$1,8633248+90.1%
California$233$1,7659321,298+38.9%
Montana$231$1,3554660+37.6%
Nevada$211$2,2286890+25.5%
Arkansas$206$1,168108174+22.3%
New Jersey$205$2,262286369+21.9%
Utah$203$1,408101143+20.8%
Iowa$203$1,289142199+20.5%
Idaho$202$1,3896789+20.2%
Delaware$200$1,7446290+19.2%
Oregon$197$1,234141209+17.5%
New Mexico$197$2,0424761+17.4%
Washington$195$1,390314452+16.2%
Maryland$195$1,725201303+15.9%
Hawaii$195$1,4072935+15.8%
Arizona$192$2,172264478+13.9%
Oklahoma$191$1,538166287+13.3%
New York$190$2,345589781+13.1%
New Hampshire$189$2,81486113+12.5%
Indiana$184$1,316190269+9.7%
Colorado$184$1,734164207+9.6%
Wyoming$182$1,2931928+8.1%
Kentucky$182$1,412183225+8.0%
Louisiana$181$1,290147202+7.7%
Kansas$180$1,159150195+7.3%
Florida$180$1,8858371,223+7.2%
Connecticut$172$2,142136192+2.2%
Illinois$172$2,124472613+2.1%
Texas$170$2,2429881,378+1.0%
District of Columbia$167$1,2945175-0.6%
Massachusetts$162$1,334435709-3.9%
Missouri$161$1,289341522-4.1%
Tennessee$159$1,515385634-5.2%
Nebraska$159$1,18786114-5.4%
Wisconsin$154$2,370244346-8.2%
Minnesota$149$1,378239326-11.4%
Ohio$149$1,410617828-11.5%
Virginia$148$1,592456743-12.0%
Michigan$146$2,145525716-13.3%
Vermont$143$8953753-14.8%
Georgia$143$1,480499731-14.9%
Pennsylvania$139$1,490683995-17.4%
North Carolina$135$1,709553840-19.7%
North Dakota$133$1,0226278-20.7%
West Virginia$133$1,65396147-20.8%
Mississippi$133$906173310-21.0%
Rhode Island$130$1,2104598-22.4%
Maine$130$1,521101154-22.9%
South Carolina$124$1,760381693-26.4%
Alabama$121$1,101309480-27.8%
South Dakota$109$1,01687141-35.2%

⚠️ 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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