10021

Fine needle aspiration biopsy, first growth

Medicare pricing data for 3,123 providers across 49 states

🤖AI Overview

Prices vary significantly by location — from $46 in North Dakota to $115 in District of Columbia. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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, first growth (HCPCS code 10021) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $90.59, but hospitals typically charge $341.21 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $90.59, your out-of-pocket cost would be approximately $18.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$90.59
Average Hospital Charge
$341.21
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$341.21
Medicare Allowed$90.59
Medicare Payment$69.37

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $69.37 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$115$3061486+27.4%
Hawaii$109$2661221+20.2%
New Jersey$103$382125271+14.0%
Connecticut$103$3464374+13.8%
California$102$361240567+12.2%
Maryland$100$31586241+10.6%
Nevada$99$257628+9.0%
New York$98$633237637+8.4%
Massachusetts$96$43393188+6.0%
South Dakota$95$334621+5.4%
Delaware$94$2521042+3.8%
Rhode Island$94$3551620+3.4%
Illinois$93$36094216+2.2%
Colorado$92$33257107+1.5%
Pennsylvania$90$305142341-0.6%
North Carolina$89$324136305-1.2%
Texas$89$315172375-1.7%
Utah$88$3423254-2.8%
New Mexico$88$315915-3.0%
Florida$87$273286682-3.5%
Tennessee$87$30454124-3.7%
Iowa$87$3143375-3.8%
Washington$87$34662279-4.0%
Indiana$87$2644592-4.1%
Arizona$87$25171272-4.3%
Kentucky$87$2703464-4.3%
Louisiana$87$28553111-4.3%
Idaho$86$2431115-4.7%
Missouri$86$29158132-4.8%
Virginia$86$33173178-4.9%
Oregon$86$34250104-5.1%
Michigan$86$24396210-5.4%
South Carolina$85$29178204-6.1%
Wisconsin$85$5334061-6.2%
Oklahoma$85$27339119-6.4%
Wyoming$85$343918-6.4%
Alabama$85$1916297-6.7%
Arkansas$83$2593475-8.0%
Georgia$83$318117270-8.4%
Kansas$82$2323999-9.2%
Nebraska$82$2733156-9.6%
Minnesota$82$3952237-9.8%
Mississippi$82$2682286-9.9%
West Virginia$80$3231624-12.2%
Ohio$79$313115287-12.8%
New Hampshire$78$3861630-14.4%
Maine$52$2531016-42.8%
Vermont$50$2411126-44.6%
North Dakota$46$2171132-48.9%

⚠️ 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

🏥 See Medicare hospital data on OpenMedicare