36226

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

Medicare pricing data for 1,748 providers across 51 states

🤖AI Overview

This procedure has a 15.6x markup — hospitals charge $4,749 but Medicare allows only $305.15. Uninsured patients may face bills 15.6 times higher than what insurance negotiates. Prices vary significantly by location — from $201 in North Dakota to $483 in Washington. 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 brain artery for diagnosis or treatment with review by radiologist (HCPCS code 36226) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $305.15, but hospitals typically charge $4,749 — a 15.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$61.03

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $305.15, your out-of-pocket cost would be approximately $61.03. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$305.15
Average Hospital Charge
$4,749
Markup Ratio
15.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,748.68
Medicare Allowed$305.15
Medicare Payment$242.62

Hospitals charge 15.6x more than what Medicare allows for this procedure. Medicare actually pays $242.62 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Washington$483$3,03734481+58.4%
Tennessee$441$4,01756555+44.5%
Georgia$385$6,74643512+26.2%
Florida$380$3,3211611,998+24.5%
Arizona$360$2,80633428+18.1%
North Carolina$359$4,34246548+17.6%
Mississippi$325$3,89525187+6.6%
Montana$317$1,687322+3.9%
Massachusetts$317$6,70130621+3.8%
New York$316$10,4811071,666+3.5%
California$311$6,4091752,274+1.8%
Texas$305$2,7971601,469+0.0%
Alaska$304$7,290328-0.3%
Puerto Rico$288$2,853725-5.8%
Illinois$287$4,266691,019-5.9%
Rhode Island$287$4,455528-5.9%
Connecticut$281$3,50616202-7.9%
New Hampshire$270$10,484418-11.6%
Hawaii$269$1,5634113-11.7%
New Jersey$269$12,05034494-11.9%
Ohio$268$3,47657991-12.3%
West Virginia$267$1,3271057-12.6%
Maryland$266$2,04920458-12.7%
Michigan$266$2,30151495-12.9%
Delaware$264$1,776223-13.5%
Pennsylvania$261$3,658801,090-14.4%
Nevada$258$3,30515115-15.5%
Louisiana$257$5,23229169-15.7%
Minnesota$255$4,21425306-16.5%
Oregon$254$5,87220200-16.7%
Alabama$253$3,71931349-17.0%
Oklahoma$252$2,49540255-17.4%
Kentucky$251$2,55024298-17.9%
Virginia$249$4,20641588-18.4%
District of Columbia$248$4,038793-18.7%
South Carolina$247$3,43722405-19.1%
Colorado$242$2,57622332-20.6%
Maine$242$1,681648-20.7%
Missouri$240$3,94037446-21.3%
Kansas$231$1,16413179-24.1%
New Mexico$230$3,302619-24.6%
Vermont$230$13,687235-24.6%
Arkansas$228$1,97318237-25.3%
Iowa$226$6,2099158-25.9%
Idaho$225$3,43414102-26.2%
Wisconsin$224$9,62433262-26.6%
Utah$223$5,55415133-26.9%
Nebraska$222$4,1001053-27.3%
South Dakota$218$1,6007140-28.4%
Indiana$218$2,12625285-28.7%
North Dakota$201$1,245875-34.1%

⚠️ 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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