31645

Aspiration of initial secretion of lung airway using an endoscope

Medicare pricing data for 7,384 providers across 50 states

🤖AI Overview

This procedure has a 7.1x markup — hospitals charge $763.20 but Medicare allows only $107.17. Uninsured patients may face bills 7.1 times higher than what insurance negotiates. Prices vary significantly by location — from $51 in Vermont to $140 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

Aspiration of initial secretion of lung airway using an endoscope (HCPCS code 31645) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $107.17, but hospitals typically charge $763.20 — a 7.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $107.17, your out-of-pocket cost would be approximately $21.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$107.17
Average Hospital Charge
$763.20
Markup Ratio
7.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$763.20
Medicare Allowed$107.17
Medicare Payment$85.14

Hospitals charge 7.1x more than what Medicare allows for this procedure. Medicare actually pays $85.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$140$1,78215110+30.4%
Oregon$134$65392255+25.0%
Mississippi$132$67049638+23.3%
Rhode Island$129$7032069+20.5%
New Jersey$129$795143579+20.1%
Maine$129$5241929+20.0%
Montana$128$5773296+19.8%
Nevada$126$56067419+17.7%
South Dakota$125$5281851+16.9%
Idaho$125$4141948+16.2%
District of Columbia$124$7223384+15.3%
Colorado$120$449151538+11.8%
Arkansas$120$46081773+11.6%
Kentucky$118$4441451,372+10.2%
Oklahoma$118$50274343+10.0%
Hawaii$118$6571940+10.0%
Nebraska$117$64871338+9.5%
Pennsylvania$114$6805241,895+6.2%
Alabama$113$716132576+5.8%
New York$113$1,4304072,155+5.6%
Florida$113$5696253,579+5.4%
South Carolina$112$732128708+4.4%
North Dakota$111$8461350+4.0%
Michigan$111$564206701+3.6%
Missouri$110$675188856+2.8%
Ohio$110$4692881,268+2.7%
Connecticut$110$85090319+2.6%
Texas$107$7404672,161+0.2%
West Virginia$107$5563976+0.0%
New Hampshire$105$1,39038206-1.8%
California$105$9436654,985-1.9%
North Carolina$105$791236764-2.5%
Indiana$103$726176838-3.9%
Georgia$103$7632722,364-4.0%
Utah$102$6523693-4.5%
Tennessee$102$616176708-4.9%
Illinois$101$9492741,854-5.4%
Minnesota$100$708134666-6.4%
Virginia$100$678198752-6.9%
Louisiana$100$65776260-6.9%
Iowa$99$74462394-7.6%
Kansas$94$49558288-12.3%
New Mexico$93$6251749-12.9%
Arizona$91$464159951-14.7%
Maryland$87$822115672-18.7%
Massachusetts$87$7652601,711-18.9%
Wisconsin$87$1,646122522-19.1%
Washington$78$584106700-27.4%
Delaware$53$1,159886-50.3%
Vermont$51$915416-52.6%

⚠️ 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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