31500

Emergent insertion of breathing tube into windpipe using an endoscope

Medicare pricing data for 60,718 providers across 52 states

🤖AI Overview

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

Emergent insertion of breathing tube into windpipe using an endoscope (HCPCS code 31500) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $138.93, but hospitals typically charge $685.66 — a 4.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$27.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $138.93, your out-of-pocket cost would be approximately $27.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$138.93
Average Hospital Charge
$685.66
Markup Ratio
4.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$685.66
Medicare Allowed$138.93
Medicare Payment$110.16

Hospitals charge 4.9x more than what Medicare allows for this procedure. Medicare actually pays $110.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$180$1,221118341+29.5%
New York$152$7514,17012,846+9.5%
District of Columbia$150$5703201,064+8.2%
Illinois$146$7512,6238,420+5.1%
New Jersey$146$7891,6215,127+4.7%
Connecticut$145$8938032,263+4.5%
Maryland$145$6611,2344,822+4.3%
Florida$144$7183,77214,437+3.9%
California$143$6855,20920,371+2.6%
Michigan$142$7732,7937,521+2.2%
Massachusetts$142$5611,6945,138+2.0%
Rhode Island$141$657268701+1.2%
Puerto Rico$140$69296227+0.9%
Delaware$140$719248704+0.7%
Pennsylvania$139$6353,5569,862+0.4%
Nevada$139$7714352,089+0.2%
Washington$139$6091,0222,725-0.1%
West Virginia$138$5974711,417-0.5%
Louisiana$138$7879453,061-0.9%
Montana$138$438159410-0.9%
Colorado$138$6078752,154-1.0%
Virginia$136$5801,6625,277-2.0%
Hawaii$136$552192506-2.1%
New Mexico$136$623316762-2.1%
Missouri$136$5941,3374,485-2.2%
Arizona$136$6991,0063,616-2.3%
Ohio$136$6672,8557,995-2.4%
Wyoming$136$75262169-2.4%
New Hampshire$135$716271726-2.9%
Georgia$135$6881,6115,034-2.9%
Oregon$135$5546481,518-3.0%
Texas$135$7733,88613,171-3.1%
Maine$134$513286666-3.5%
Utah$134$564355782-3.8%
North Dakota$133$549198498-4.0%
Vermont$133$609118295-4.4%
South Carolina$133$6591,0973,475-4.5%
North Carolina$132$6172,0195,856-4.7%
Kentucky$132$5829573,490-4.9%
Alabama$132$6728742,751-5.0%
Minnesota$131$6741,1312,504-5.8%
South Dakota$131$669203539-5.8%
Kansas$131$5954941,351-6.0%
Oklahoma$130$6897682,912-6.1%
Wisconsin$130$8461,1182,558-6.4%
Mississippi$130$7645872,664-6.5%
Indiana$129$5601,2614,283-6.8%
Arkansas$129$6175752,183-7.2%
Idaho$129$606189444-7.3%
Iowa$129$5514601,378-7.5%
Tennessee$128$6521,2884,381-7.9%
Nebraska$127$463351916-8.3%

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

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