36223

Insertion of tube into intracranial artery for diagnosis or treatment with review by radiologist

Medicare pricing data for 2,319 providers across 48 states

🤖AI Overview

This procedure has a 12.1x markup — hospitals charge $4,380 but Medicare allows only $362.59. Uninsured patients may face bills 12.1 times higher than what insurance negotiates. Prices vary significantly by location — from $200 in Idaho to $578 in Oklahoma. 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 intracranial artery for diagnosis or treatment with review by radiologist (HCPCS code 36223) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $362.59, but hospitals typically charge $4,380 — a 12.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$72.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $362.59, your out-of-pocket cost would be approximately $72.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$362.59
Average Hospital Charge
$4,380
Markup Ratio
12.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,380.27
Medicare Allowed$362.59
Medicare Payment$288.26

Hospitals charge 12.1x more than what Medicare allows for this procedure. Medicare actually pays $288.26 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Oklahoma$578$2,99888440+59.4%
Oregon$502$5,80926182+38.4%
Georgia$497$5,52367298+37.0%
Florida$443$2,5422351,594+22.2%
Arizona$443$2,29351494+22.1%
Maryland$433$1,91140424+19.5%
Texas$427$2,5922441,518+17.8%
Alabama$410$3,16859318+13.0%
Alaska$400$3,541228+10.3%
Michigan$399$2,40686527+10.0%
New York$383$12,6611121,496+5.6%
California$362$5,0182101,211-0.0%
North Carolina$348$4,62158413-3.9%
Tennessee$348$2,31968426-4.0%
Louisiana$331$4,31747152-8.7%
Montana$331$1,447544-8.7%
West Virginia$317$1,3631452-12.6%
Massachusetts$314$8,57739453-13.4%
Mississippi$309$2,64526175-14.7%
Pennsylvania$306$3,09292915-15.6%
New Jersey$302$10,06948290-16.7%
Indiana$298$2,55347303-17.8%
Illinois$298$4,56991737-17.9%
District of Columbia$297$4,171848-18.1%
Missouri$295$3,88354411-18.7%
Utah$289$3,80816108-20.2%
Ohio$289$3,13484888-20.4%
Nevada$288$2,73018131-20.7%
Vermont$285$14,608223-21.4%
Connecticut$285$3,51417140-21.5%
South Dakota$285$1,6679143-21.5%
Kentucky$281$2,67222260-22.4%
Washington$278$1,50432176-23.3%
North Dakota$269$2,8181152-25.9%
Virginia$268$3,02648366-26.0%
South Carolina$257$3,02829242-29.2%
Arkansas$252$2,2961980-30.6%
Maine$251$2,398729-30.9%
Wisconsin$248$6,08432136-31.5%
Iowa$245$6,24416154-32.5%
Kansas$242$1,0731572-33.2%
New Mexico$242$2,693830-33.4%
Colorado$240$2,47220270-33.9%
Minnesota$237$3,42826309-34.5%
Hawaii$235$1,140548-35.1%
Nebraska$231$3,6591156-36.2%
Rhode Island$210$4,086627-42.1%
Idaho$200$1,6401663-44.9%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber