01360

Anesthesia for procedure on lower 1/3rd of thigh bone

Medicare pricing data for 13,396 providers across 52 states

🤖AI Overview

This procedure has a 10.4x markup — hospitals charge $2,230 but Medicare allows only $215.43. Uninsured patients may face bills 10.4 times higher than what insurance negotiates. Prices vary significantly by location — from $150 in Alabama to $370 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 procedure on lower 1/3rd of thigh bone (HCPCS code 01360) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $215.43, but hospitals typically charge $2,230 — a 10.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$43.09

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $215.43, your out-of-pocket cost would be approximately $43.09. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$215.43
Average Hospital Charge
$2,230
Markup Ratio
10.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,229.86
Medicare Allowed$215.43
Medicare Payment$170.18

Hospitals charge 10.4x more than what Medicare allows for this procedure. Medicare actually pays $170.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$370$2,2912831+72.0%
Utah$336$2,0628598+55.8%
Wyoming$330$1,9831624+53.2%
Oregon$303$2,019121141+40.5%
Montana$298$1,6025364+38.2%
California$296$2,396792969+37.3%
Idaho$290$2,0326269+34.5%
Iowa$280$1,745144198+29.7%
Washington$276$2,130245315+27.9%
Puerto Rico$275$2,2951213+27.7%
Arizona$271$3,050225266+25.7%
Nevada$268$2,58286108+24.4%
Nebraska$261$1,597112141+21.2%
District of Columbia$250$1,9516074+16.2%
New York$249$3,174605741+15.7%
Massachusetts$244$1,863370469+13.1%
Rhode Island$242$2,4462630+12.1%
New Mexico$240$2,4304960+11.4%
Illinois$236$2,786471575+9.6%
New Jersey$233$2,883299382+8.3%
Maryland$229$2,229262379+6.4%
Arkansas$226$1,700112144+4.8%
Florida$225$2,5931,0141,266+4.2%
Kentucky$222$1,833198231+3.0%
Oklahoma$221$2,119173233+2.6%
New Hampshire$221$3,2537893+2.6%
Colorado$219$2,144197231+1.6%
Delaware$218$1,9354554+1.0%
Kansas$213$1,421165202-1.1%
Vermont$211$1,3193140-2.0%
Hawaii$210$1,8652325-2.5%
Indiana$210$1,958314416-2.6%
Connecticut$208$2,156159197-3.5%
Wisconsin$207$3,166242299-3.7%
Ohio$207$1,830553667-4.1%
Louisiana$205$1,743192220-4.7%
Texas$201$2,6981,0281,266-6.7%
Tennessee$200$2,067400495-7.0%
Michigan$191$2,553449514-11.5%
Mississippi$188$1,266156194-12.8%
Missouri$187$1,678415562-13.2%
Maine$186$2,25292115-13.5%
Pennsylvania$179$1,825706847-17.1%
Virginia$177$2,185415538-17.6%
South Dakota$176$1,91285101-18.1%
West Virginia$172$1,97783108-20.0%
North Dakota$171$1,8305769-20.8%
Minnesota$168$1,666347412-22.1%
North Carolina$167$1,999538690-22.4%
Georgia$166$1,789470573-22.7%
South Carolina$158$2,181314407-26.5%
Alabama$150$1,678181225-30.3%

⚠️ 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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