31652

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes

Medicare pricing data for 3,982 providers across 50 states

🤖AI Overview

This procedure has a 9.3x markup — hospitals charge $1,811 but Medicare allows only $194.58. Uninsured patients may face bills 9.3 times higher than what insurance negotiates. Prices vary significantly by location — from $170 in Tennessee to $575 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

Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes (HCPCS code 31652) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $194.58, but hospitals typically charge $1,811 — a 9.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$38.92

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $194.58, your out-of-pocket cost would be approximately $38.92. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$194.58
Average Hospital Charge
$1,811
Markup Ratio
9.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,810.76
Medicare Allowed$194.58
Medicare Payment$153.69

Hospitals charge 9.3x more than what Medicare allows for this procedure. Medicare actually pays $153.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$575$7,629749+195.8%
Missouri$226$1,411115680+16.2%
Alabama$218$1,32548275+12.1%
New York$218$2,8842131,431+11.9%
New Jersey$211$2,33381554+8.7%
Wisconsin$211$3,04188530+8.3%
Rhode Island$209$1,3351039+7.6%
California$204$2,5012451,672+4.7%
Maine$203$6761846+4.6%
New Mexico$202$1,9041250+3.8%
New Hampshire$201$2,22730123+3.4%
Pennsylvania$201$1,5562021,364+3.1%
South Dakota$200$98114111+2.8%
Texas$199$1,9462751,554+2.2%
North Dakota$198$1,2791382+1.9%
Arkansas$198$1,30752354+1.9%
Vermont$198$4,370671+1.6%
Illinois$197$2,3831621,428+1.5%
Utah$197$1,44115106+1.5%
North Carolina$197$2,129130944+1.3%
Oklahoma$194$1,28252266-0.3%
West Virginia$192$79344195-1.4%
Oregon$191$2,55851216-1.9%
Maryland$191$1,82343485-2.1%
Connecticut$190$1,79544240-2.3%
Massachusetts$190$1,648107671-2.3%
Kansas$190$1,01535376-2.5%
Florida$189$1,3772631,721-3.0%
Minnesota$189$2,41374491-3.0%
Montana$189$9591383-3.1%
Colorado$188$1,16353310-3.3%
Michigan$188$1,164159797-3.3%
Idaho$188$6281482-3.4%
Virginia$188$1,884129839-3.4%
Louisiana$188$1,31658319-3.5%
Ohio$186$1,3551971,049-4.4%
Washington$185$1,05680465-5.0%
Kentucky$183$99796574-5.9%
Arizona$182$85464531-6.6%
Nebraska$180$2,15440240-7.4%
South Carolina$178$1,38181553-8.3%
Iowa$178$2,30845379-8.3%
Georgia$176$1,953129918-9.6%
Nevada$176$2,28925162-9.7%
Hawaii$176$92312111-9.7%
Delaware$175$1,77612179-9.9%
Indiana$174$1,806134755-10.3%
District of Columbia$174$95012162-10.6%
Mississippi$172$1,95244254-11.6%
Tennessee$170$1,150113799-12.8%

⚠️ 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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