22514

Treatment of broken lower spine bone with placement of stabilizing device

Medicare pricing data for 5,484 providers across 51 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $11,533 but Medicare allows only $2,131. Uninsured patients may face bills 5.4 times higher than what insurance negotiates. Prices vary significantly by location — from $421 in Vermont to $6,504 in Alaska. 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 lower spine bone with placement of stabilizing device (HCPCS code 22514) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,131, but hospitals typically charge $11,533 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$426.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,131, your out-of-pocket cost would be approximately $426.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2,131
Average Hospital Charge
$11,533
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$11,532.83
Medicare Allowed$2,131.30
Medicare Payment$1,697.93

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $1,698 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$6,504$36,867215+205.1%
Arizona$4,839$20,292141620+127.1%
Utah$4,162$16,82773294+95.3%
New Jersey$3,343$33,418104355+56.8%
Florida$3,174$16,2096333,013+48.9%
New York$2,791$20,084202846+30.9%
Hawaii$2,745$6,091864+28.8%
Virginia$2,655$13,2251831,029+24.6%
Oklahoma$2,639$10,567108666+23.8%
Oregon$2,633$11,03751117+23.6%
Tennessee$2,580$10,957137553+21.0%
Washington$2,570$8,73880327+20.6%
California$2,320$12,3253741,338+8.8%
Nevada$2,292$13,77149105+7.6%
Maryland$2,212$11,230120355+3.8%
New Mexico$2,207$7,8362890+3.6%
New Hampshire$2,137$6,7152092+0.3%
Connecticut$2,124$13,33137113-0.3%
Minnesota$2,090$12,14861173-1.9%
Alabama$2,087$8,069102439-2.1%
Idaho$2,042$7,0622592-4.2%
North Carolina$2,000$8,540175615-6.2%
Texas$1,997$10,9675432,041-6.3%
Arkansas$1,899$7,63688345-10.9%
Kentucky$1,839$7,18864251-13.7%
Colorado$1,782$9,27790246-16.4%
Maine$1,738$5,7081645-18.5%
Louisiana$1,660$10,309100276-22.1%
Georgia$1,585$10,973209775-25.6%
South Dakota$1,466$6,1552674-31.2%
Mississippi$1,441$6,77547397-32.4%
Michigan$1,441$8,549172680-32.4%
Illinois$1,401$11,9212451,034-34.3%
South Carolina$1,350$7,09792381-36.7%
Indiana$1,318$10,548154680-38.2%
Nebraska$1,230$9,02940192-42.3%
Kansas$1,087$4,33569393-49.0%
Pennsylvania$946$5,411203604-55.6%
Ohio$932$5,599195727-56.2%
Missouri$910$5,278110585-57.3%
Wisconsin$851$8,64174203-60.1%
Massachusetts$726$5,89898536-65.9%
Wyoming$614$8,570631-71.2%
Rhode Island$609$8,5682159-71.4%
Delaware$543$7,4291267-74.5%
District of Columbia$496$6,461953-76.7%
Montana$469$4,4711026-78.0%
West Virginia$460$1,9312262-78.4%
North Dakota$452$2,0211354-78.8%
Iowa$451$3,39527105-78.8%
Vermont$421$17,915211-80.2%

⚠️ 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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