10006

Fine needle aspiration biopsy using ultrasound guidance, each additional growth

Medicare pricing data for 7,161 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, each additional growth (HCPCS code 10006) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $55.07, but hospitals typically charge $251.51 — a 4.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.01

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $55.07, your out-of-pocket cost would be approximately $11.01. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$55.07
Average Hospital Charge
$251.51
Markup Ratio
4.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$251.51
Medicare Allowed$55.07
Medicare Payment$43.18

Hospitals charge 4.6x more than what Medicare allows for this procedure. Medicare actually pays $43.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$66$3502772+19.4%
New York$65$2764764,244+18.4%
New Jersey$60$2382341,192+8.3%
California$60$2736082,549+8.1%
District of Columbia$59$1422290+6.5%
Maryland$57$165156781+4.2%
Florida$57$2465192,243+3.3%
Delaware$56$26727250+2.6%
Arizona$55$250120679+0.5%
Nevada$54$19968319-1.3%
Massachusetts$54$210199759-1.8%
Rhode Island$54$1813597-2.0%
Connecticut$53$21090305-2.9%
Illinois$53$2883481,343-3.4%
Georgia$53$383177752-3.5%
Tennessee$53$212125779-3.5%
Texas$53$2965722,191-4.2%
Louisiana$53$32285258-4.4%
Virginia$52$220193743-4.7%
Alabama$52$13174191-5.0%
Wyoming$52$2282578-5.7%
Puerto Rico$52$6116107-6.1%
Oregon$51$176100309-6.6%
Ohio$51$267209624-6.8%
Arkansas$51$12760285-6.9%
Michigan$51$164223699-7.5%
New Hampshire$51$26641121-7.6%
Washington$51$174172581-7.8%
Indiana$51$199140629-7.9%
Mississippi$51$14444109-8.0%
Utah$51$14862226-8.1%
Oklahoma$51$24188392-8.2%
Missouri$50$182141453-8.7%
Colorado$50$288137411-8.8%
New Mexico$50$25242139-8.8%
North Carolina$50$258277842-9.0%
Vermont$50$167929-9.1%
Pennsylvania$50$3493301,236-9.4%
Kansas$50$16852126-10.0%
South Dakota$50$17727103-10.1%
Kentucky$49$17086229-10.8%
Iowa$49$17972243-10.9%
Montana$49$1582147-11.7%
Maine$49$14237110-11.8%
Minnesota$49$227165402-11.8%
North Dakota$48$18219104-13.1%
Wisconsin$48$397149491-13.3%
South Carolina$48$233111460-13.4%
Hawaii$47$1521347-14.1%
Nebraska$46$17357168-16.6%
West Virginia$45$27127141-17.7%
Idaho$44$2743768-19.5%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber