22513

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance

Medicare pricing data for 4,936 providers across 49 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $11,241 but Medicare allows only $2,094. Uninsured patients may face bills 5.4 times higher than what insurance negotiates. Prices vary significantly by location — from $481 in North Dakota to $4,849 in Arizona. 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

Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance (HCPCS code 22513) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,094, but hospitals typically charge $11,241 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$418.76

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,094, your out-of-pocket cost would be approximately $418.76. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2,094
Average Hospital Charge
$11,241
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$11,240.79
Medicare Allowed$2,093.82
Medicare Payment$1,668.61

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $1,669 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$4,849$20,544124504+131.6%
Utah$4,129$15,37466243+97.2%
New Jersey$3,395$31,93494256+62.1%
Florida$3,302$15,7055622,647+57.7%
Hawaii$3,072$7,405924+46.7%
Oregon$2,940$10,7134289+40.4%
Oklahoma$2,881$12,035105747+37.6%
Virginia$2,759$13,621179868+31.8%
Washington$2,694$8,87563291+28.7%
Tennessee$2,538$10,461126446+21.2%
Maryland$2,434$11,45088268+16.3%
New York$2,361$20,273165765+12.7%
California$2,355$13,5493661,169+12.5%
Connecticut$2,311$13,6093693+10.4%
New Mexico$2,243$9,1903062+7.1%
Maine$2,054$6,4481650-1.9%
Alabama$1,995$7,96494381-4.7%
Arkansas$1,949$7,74874335-6.9%
North Carolina$1,925$8,590172561-8.1%
Nevada$1,845$10,7244185-11.9%
Texas$1,841$10,0294911,698-12.1%
Minnesota$1,810$11,73046141-13.6%
Louisiana$1,716$10,46877217-18.0%
Colorado$1,700$9,63687256-18.8%
Georgia$1,518$11,395192674-27.5%
Idaho$1,486$5,4872293-29.0%
Mississippi$1,460$7,27541328-30.3%
Michigan$1,443$8,995159559-31.1%
Nebraska$1,429$9,85450194-31.7%
South Carolina$1,391$7,22679337-33.6%
Kentucky$1,331$6,81656214-36.4%
Kansas$1,330$4,63872418-36.5%
Indiana$1,236$9,437135613-41.0%
Illinois$1,215$10,603200778-42.0%
Wisconsin$1,102$10,93472212-47.4%
Ohio$926$4,854165760-55.8%
Pennsylvania$860$4,993174539-58.9%
Missouri$856$5,263104546-59.1%
Massachusetts$699$5,97689473-66.6%
Rhode Island$585$7,7512257-72.1%
District of Columbia$545$7,181956-74.0%
Delaware$535$7,1791470-74.5%
Montana$508$6,1441328-75.7%
New Hampshire$502$1,8311664-76.0%
South Dakota$501$2,3531862-76.1%
West Virginia$498$2,5121641-76.2%
Iowa$483$3,5152583-76.9%
Vermont$482$10,498316-77.0%
North Dakota$481$2,7351168-77.0%

⚠️ 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