36215

Insertion of tube into chest or arm artery, each first order branch

Medicare pricing data for 3,452 providers across 47 states

🤖AI Overview

This procedure has a 6.6x markup — hospitals charge $2,023 but Medicare allows only $307.56. Uninsured patients may face bills 6.6 times higher than what insurance negotiates. Prices vary significantly by location — from $102 in Nebraska to $483 in New York. 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

Insertion of tube into chest or arm artery, each first order branch (HCPCS code 36215) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $307.56, but hospitals typically charge $2,023 — a 6.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$61.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $307.56, your out-of-pocket cost would be approximately $61.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$307.56
Average Hospital Charge
$2,023
Markup Ratio
6.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,022.73
Medicare Allowed$307.56
Medicare Payment$245.02

Hospitals charge 6.6x more than what Medicare allows for this procedure. Medicare actually pays $245.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$483$3,2031762,514+57.2%
District of Columbia$472$2,8651452+53.4%
Indiana$425$2,137661,392+38.3%
New Jersey$423$1,940911,015+37.5%
California$396$2,8403182,475+28.9%
Texas$368$2,1963473,780+19.8%
Georgia$335$2,5971111,591+9.0%
Florida$334$1,8972501,860+8.7%
Michigan$327$1,984113934+6.3%
Connecticut$318$4,20924107+3.3%
Puerto Rico$317$1,51511116+3.1%
Maryland$317$1,98569602+2.9%
North Carolina$306$1,7311291,082-0.5%
Virginia$293$1,666101591-4.8%
Colorado$287$1,87960273-6.5%
Kentucky$287$2,32438176-6.6%
Alabama$278$1,61958229-9.5%
South Carolina$235$1,86161386-23.7%
Tennessee$233$1,46078538-24.2%
Pennsylvania$221$1,864160993-28.1%
Arizona$214$1,56083767-30.5%
Oklahoma$207$1,63351123-32.7%
Delaware$190$81618103-38.4%
Illinois$187$1,0061423,037-39.4%
Arkansas$170$1,78643208-44.9%
Massachusetts$169$1,80894602-45.2%
Minnesota$168$1,97050201-45.3%
Louisiana$153$1,93767274-50.1%
Washington$150$1,12459208-51.4%
Ohio$143$1,433114755-53.4%
Kansas$139$81232295-54.9%
Rhode Island$137$780743-55.6%
South Dakota$130$6111323-57.8%
Mississippi$123$1,4142338-59.9%
Oregon$121$1,5253982-60.7%
New Mexico$117$2,0521029-61.9%
Maine$115$6471429-62.7%
Missouri$113$1,26769250-63.2%
Idaho$113$1,0391737-63.4%
Montana$113$1,3261328-63.4%
Nevada$112$63129424-63.5%
West Virginia$110$1,1071958-64.1%
Utah$109$1,334925-64.6%
Wisconsin$108$4,15655132-65.0%
Iowa$106$3,5642381-65.6%
New Hampshire$104$1,324962-66.1%
Nebraska$102$1,7452051-66.9%

⚠️ 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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