10005

Fine needle aspiration biopsy using ultrasound guidance, first growth

Medicare pricing data for 14,874 providers across 52 states

🤖AI Overview

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

Fine needle aspiration biopsy using ultrasound guidance, first growth (HCPCS code 10005) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $99.87, but hospitals typically charge $436.61 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$19.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $99.87, your out-of-pocket cost would be approximately $19.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$99.87
Average Hospital Charge
$436.61
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$436.61
Medicare Allowed$99.87
Medicare Payment$76.47

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $76.47 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$127$59192812,039+26.7%
New Jersey$116$4664384,572+16.1%
California$115$5071,33213,355+15.5%
Alaska$114$64856372+14.3%
Nevada$113$3931271,251+12.9%
District of Columbia$112$26552521+12.3%
Delaware$109$44642683+9.0%
Arizona$109$4512752,787+8.9%
Florida$109$4131,0279,667+8.7%
Maryland$107$3182682,990+7.0%
Tennessee$104$3883293,191+4.1%
Connecticut$102$3671821,318+2.4%
Georgia$100$6254033,375+0.4%
Massachusetts$98$3664054,229-2.0%
Puerto Rico$97$13333248-3.3%
Virginia$96$3363963,751-3.9%
Texas$95$4781,1199,172-4.6%
Mississippi$95$279128824-4.9%
Nebraska$94$470105852-5.5%
North Carolina$94$4015784,194-5.6%
Rhode Island$94$34373503-5.8%
Alabama$94$2372101,328-6.3%
Arkansas$94$2821281,103-6.4%
Kansas$93$3291341,124-6.9%
Washington$93$3363482,508-7.0%
Utah$93$268134928-7.3%
Oregon$92$3082301,546-7.9%
Illinois$92$4266085,808-8.0%
Wyoming$91$39742316-9.0%
Louisiana$90$4131971,381-9.9%
New Hampshire$89$437111718-10.8%
Indiana$89$3442722,534-11.1%
New Mexico$88$574105797-11.8%
Ohio$87$4264743,288-12.5%
Oklahoma$86$3541661,767-14.1%
Michigan$86$2724633,400-14.3%
Montana$86$28160385-14.3%
Iowa$85$3581621,324-15.3%
Colorado$84$4002701,824-15.5%
Hawaii$84$27036264-15.7%
South Dakota$84$31469533-15.8%
Wisconsin$84$7783362,262-16.2%
Missouri$84$3302782,374-16.4%
Pennsylvania$83$5296215,595-16.9%
South Carolina$83$4112132,357-17.0%
Minnesota$82$4093602,183-18.0%
Kentucky$80$2741941,259-19.7%
Maine$76$23891516-23.5%
West Virginia$75$28286830-25.2%
Idaho$74$35498402-25.9%
Vermont$72$34930251-27.7%
North Dakota$70$53234329-29.7%

⚠️ 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

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