Biopsy of fingernail or toenail
Medicare pricing data for 5,180 providers across 48 states
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
Biopsy of fingernail or toenail (HCPCS code 11755) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $111.14, but hospitals typically charge $249.85 — a 2.2x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $111.14, your out-of-pocket cost would be approximately $22.23. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $83.96 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $134 | $331 | 240 | 2,523 | +20.4% |
| New York | $129 | $356 | 558 | 4,549 | +16.5% |
| Hawaii | $129 | $272 | 9 | 13 | +16.0% |
| Connecticut | $127 | $305 | 37 | 244 | +14.1% |
| Washington | $119 | $297 | 65 | 225 | +7.1% |
| Minnesota | $119 | $319 | 24 | 65 | +6.9% |
| New Hampshire | $118 | $209 | 19 | 103 | +6.4% |
| Rhode Island | $117 | $206 | 10 | 60 | +5.0% |
| Delaware | $116 | $282 | 19 | 60 | +4.5% |
| Pennsylvania | $115 | $240 | 191 | 756 | +3.5% |
| Maryland | $115 | $221 | 72 | 537 | +3.2% |
| Florida | $114 | $252 | 580 | 6,008 | +2.8% |
| Colorado | $114 | $266 | 83 | 679 | +2.4% |
| Iowa | $114 | $288 | 20 | 47 | +2.2% |
| Virginia | $113 | $234 | 114 | 1,264 | +2.0% |
| Illinois | $113 | $225 | 287 | 3,046 | +1.2% |
| Montana | $112 | $318 | 9 | 19 | +1.2% |
| Michigan | $112 | $211 | 138 | 567 | +0.8% |
| Missouri | $112 | $283 | 63 | 216 | +0.7% |
| Texas | $111 | $263 | 380 | 3,959 | -0.3% |
| California | $111 | $210 | 517 | 14,158 | -0.5% |
| Maine | $110 | $184 | 9 | 34 | -0.8% |
| Kansas | $110 | $203 | 20 | 331 | -1.0% |
| North Carolina | $110 | $259 | 104 | 284 | -1.5% |
| Massachusetts | $109 | $347 | 106 | 927 | -1.8% |
| Tennessee | $109 | $259 | 123 | 1,683 | -2.3% |
| South Carolina | $107 | $233 | 84 | 822 | -3.8% |
| Indiana | $107 | $234 | 73 | 983 | -4.1% |
| Kentucky | $105 | $204 | 51 | 192 | -5.1% |
| Oklahoma | $105 | $258 | 30 | 95 | -5.2% |
| Nevada | $105 | $273 | 38 | 378 | -5.6% |
| Mississippi | $103 | $284 | 14 | 43 | -7.0% |
| Wisconsin | $103 | $378 | 46 | 188 | -7.5% |
| Georgia | $102 | $250 | 139 | 1,619 | -8.3% |
| Arkansas | $102 | $216 | 28 | 273 | -8.4% |
| Ohio | $101 | $230 | 187 | 907 | -9.0% |
| West Virginia | $101 | $182 | 13 | 81 | -9.2% |
| Arizona | $101 | $217 | 158 | 2,382 | -9.6% |
| South Dakota | $100 | $254 | 6 | 11 | -9.9% |
| North Dakota | $98 | $222 | 7 | 36 | -12.2% |
| Louisiana | $97 | $357 | 65 | 408 | -12.3% |
| Idaho | $97 | $216 | 22 | 83 | -12.7% |
| Puerto Rico | $97 | $125 | 19 | 347 | -12.8% |
| Utah | $97 | $242 | 44 | 755 | -13.0% |
| Nebraska | $95 | $289 | 34 | 109 | -14.2% |
| Alabama | $94 | $208 | 44 | 443 | -15.0% |
| New Mexico | $93 | $269 | 37 | 606 | -16.6% |
| Oregon | $86 | $164 | 53 | 1,733 | -22.3% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber