01220

Anesthesia for closed procedure on upper 2/3rd of thigh bone

Medicare pricing data for 10,498 providers across 51 states

🤖AI Overview

This procedure has a 10.4x markup — hospitals charge $1,484 but Medicare allows only $142.78. Uninsured patients may face bills 10.4 times higher than what insurance negotiates. Prices vary significantly by location — from $100 in Alabama to $256 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 closed procedure on upper 2/3rd of thigh bone (HCPCS code 01220) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $142.78, but hospitals typically charge $1,484 — a 10.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$28.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $142.78, your out-of-pocket cost would be approximately $28.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$142.78
Average Hospital Charge
$1,484
Markup Ratio
10.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,484.05
Medicare Allowed$142.78
Medicare Payment$111.96

Hospitals charge 10.4x more than what Medicare allows for this procedure. Medicare actually pays $111.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$256$1,4102735+79.3%
California$201$1,604624769+41.0%
Oregon$194$1,46684105+35.9%
Utah$190$1,2367591+33.4%
Hawaii$185$1,3851722+29.6%
Idaho$183$1,3534757+28.5%
Montana$183$1,0235263+28.1%
Wyoming$181$1,5501417+26.9%
Washington$178$1,291216264+25.0%
Nebraska$178$1,10275100+24.6%
New Mexico$176$1,7094654+23.5%
Nevada$170$1,55293115+18.7%
New York$168$2,324597777+17.9%
Arkansas$168$1,0517897+17.4%
Iowa$167$1,08887112+17.3%
Arizona$167$1,795208247+16.8%
District of Columbia$161$1,5193848+12.9%
New Jersey$160$1,650236283+12.1%
Maryland$160$1,686192250+12.0%
Indiana$157$1,313190226+9.8%
Kansas$154$89997114+7.7%
Illinois$150$1,830399497+4.9%
Colorado$148$1,480165194+3.8%
Florida$147$1,631704882+3.0%
Oklahoma$146$1,61496137+2.6%
Rhode Island$146$1,2273337+2.6%
Kentucky$145$1,499144163+1.4%
New Hampshire$140$1,6598199-1.7%
Tennessee$140$1,335314385-2.2%
Massachusetts$139$1,173412593-2.4%
Ohio$138$1,082351397-3.5%
Wisconsin$135$2,061192249-5.2%
Missouri$132$1,241279356-7.3%
Vermont$131$1,1492944-8.0%
Connecticut$131$1,698165212-8.3%
North Dakota$130$1,2523237-8.8%
Texas$130$1,6938391,057-9.1%
Louisiana$128$1,048125222-10.4%
Maine$123$1,3637692-13.6%
Virginia$122$1,524319408-14.3%
Pennsylvania$121$1,216548667-15.5%
West Virginia$120$1,2865061-16.0%
Michigan$119$1,586325380-16.7%
Minnesota$116$1,132259310-18.7%
Georgia$116$1,166357455-19.0%
South Dakota$116$1,4744760-19.1%
South Carolina$113$1,326211255-20.6%
Delaware$113$1,4003250-20.6%
North Carolina$112$1,470431560-21.7%
Mississippi$110$911151264-23.0%
Alabama$100$1,121229330-29.6%

⚠️ 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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