22842

Placement of stabilizing device to back, 3-6 spine bone segments

Medicare pricing data for 9,901 providers across 52 states

🤖AI Overview

This procedure has a 6.7x markup — hospitals charge $3,410 but Medicare allows only $510.20. Uninsured patients may face bills 6.7 times higher than what insurance negotiates. 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 stabilizing device to back, 3-6 spine bone segments (HCPCS code 22842) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $510.20, but hospitals typically charge $3,410 — a 6.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$102.04

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $510.20, your out-of-pocket cost would be approximately $102.04. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$510.20
Average Hospital Charge
$3,410
Markup Ratio
6.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,410.12
Medicare Allowed$510.20
Medicare Payment$407.31

Hospitals charge 6.7x more than what Medicare allows for this procedure. Medicare actually pays $407.31 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$746$2,63832344+46.2%
Vermont$656$3,4031057+28.6%
Puerto Rico$643$1,6551046+26.1%
New York$622$5,2045153,025+22.0%
Massachusetts$606$4,3662041,960+18.7%
Maryland$592$2,7222212,590+15.9%
Illinois$585$5,6843352,827+14.7%
Pennsylvania$577$3,9073953,331+13.0%
Michigan$555$3,4572992,496+8.7%
Rhode Island$551$5,10341324+8.0%
California$542$3,3958056,751+6.2%
Florida$539$3,5547826,422+5.6%
West Virginia$535$2,27444320+4.8%
Virginia$535$2,7962402,611+4.8%
Alaska$529$5,84840319+3.8%
New Mexico$523$2,98837207+2.4%
Kentucky$521$2,4421241,056+2.1%
New Jersey$519$8,4102741,556+1.6%
Ohio$515$2,3933893,875+1.0%
Montana$511$2,73746395+0.2%
Connecticut$509$4,775162872-0.2%
Hawaii$508$1,67716154-0.5%
Georgia$505$3,2933062,385-1.1%
Mississippi$504$4,31864502-1.3%
Missouri$499$3,3092011,688-2.3%
Texas$497$2,8177446,137-2.6%
Maine$495$1,77540129-3.0%
Wyoming$485$2,51025151-4.8%
Arizona$480$2,6462502,581-5.9%
Louisiana$478$3,8791851,612-6.3%
Arkansas$477$2,09370561-6.5%
Utah$475$2,154105902-6.8%
South Carolina$474$2,6711671,564-7.1%
Nevada$472$6,751109744-7.4%
Colorado$468$2,4892512,717-8.3%
Oregon$468$2,089131723-8.3%
Tennessee$468$2,5722262,230-8.3%
Oklahoma$463$2,2951221,586-9.2%
North Carolina$457$2,4283543,163-10.4%
Minnesota$453$3,1311811,378-11.1%
Washington$453$1,7472511,970-11.2%
New Hampshire$452$6,50044234-11.3%
Kansas$444$2,3171061,459-13.0%
Wisconsin$442$9,1941641,041-13.3%
Iowa$438$2,88474872-14.2%
Indiana$435$3,3101982,087-14.7%
North Dakota$422$1,73123343-17.3%
Alabama$422$2,8621711,391-17.3%
Delaware$408$4,53841587-20.0%
Nebraska$400$2,46280865-21.6%
South Dakota$388$1,80558481-23.9%
Idaho$387$4,04379653-24.2%

⚠️ 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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