19285

Placement of locating device in breast using ultrasound guidance, first growth

Medicare pricing data for 6,152 providers across 51 states

🤖AI Overview

This procedure has a 6.8x markup — hospitals charge $854.54 but Medicare allows only $126.18. Uninsured patients may face bills 6.8 times higher than what insurance negotiates. Prices vary significantly by location — from $72 in Vermont to $259 in Wyoming. 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

Placement of locating device in breast using ultrasound guidance, first growth (HCPCS code 19285) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $126.18, but hospitals typically charge $854.54 — a 6.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$25.24

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $126.18, your out-of-pocket cost would be approximately $25.24. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$126.18
Average Hospital Charge
$854.54
Markup Ratio
6.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$854.54
Medicare Allowed$126.18
Medicare Payment$99.03

Hospitals charge 6.8x more than what Medicare allows for this procedure. Medicare actually pays $99.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$259$9641967+105.3%
New Mexico$233$1,16331196+84.8%
Maryland$214$971114599+69.5%
Washington$176$822152647+39.8%
North Carolina$176$1,1222351,018+39.3%
Arizona$175$819102636+38.6%
Minnesota$171$813170732+35.9%
Nevada$169$9512762+33.6%
California$162$1,1275312,891+28.2%
Hawaii$153$7942388+21.4%
Montana$150$63732139+19.0%
Florida$149$9953691,962+18.2%
New Jersey$145$1,061127494+14.5%
Oregon$142$79990341+12.7%
Arkansas$141$58647194+11.9%
Colorado$140$661114578+11.0%
New York$139$1,4103051,298+10.1%
New Hampshire$132$1,22536136+4.3%
South Dakota$131$64127117+3.5%
Texas$125$1,0123751,791-0.7%
Wisconsin$120$1,460201614-4.6%
District of Columbia$117$1,21339298-7.4%
Utah$114$51242153-9.5%
Iowa$112$67664161-11.3%
Indiana$111$630150798-11.7%
Kansas$107$59770298-14.9%
Nebraska$106$95961251-15.9%
Illinois$105$6342891,249-16.6%
Tennessee$104$702136527-17.8%
Alaska$103$1,5002088-18.2%
Massachusetts$100$512195913-20.7%
Virginia$98$8391771,178-22.6%
Oklahoma$97$65054290-22.9%
Georgia$93$822173714-26.5%
Ohio$93$7802541,217-26.5%
Maine$92$33333135-27.3%
Connecticut$91$70091317-27.7%
Pennsylvania$89$5442691,110-29.1%
Kentucky$89$52678374-29.2%
Michigan$88$497208821-30.2%
Louisiana$87$52579351-31.4%
Rhode Island$85$39022112-32.7%
Missouri$85$637156758-32.9%
Delaware$83$27117148-34.2%
North Dakota$80$4981974-36.5%
South Carolina$80$54782491-36.6%
Mississippi$80$95457244-36.7%
West Virginia$78$35027113-37.8%
Alabama$78$61198359-37.8%
Idaho$78$46937200-38.1%
Vermont$72$432843-42.7%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber