36247

Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch

Medicare pricing data for 8,935 providers across 52 states

🤖AI Overview

This procedure has a 7.6x markup — hospitals charge $3,308 but Medicare allows only $436.75. Uninsured patients may face bills 7.6 times higher than what insurance negotiates. Prices vary significantly by location — from $174 in Nebraska to $569 in Maryland. 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 abdominal, pelvic, or leg artery, initial third order branch (HCPCS code 36247) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $436.75, but hospitals typically charge $3,308 — a 7.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$87.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $436.75, your out-of-pocket cost would be approximately $87.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$436.75
Average Hospital Charge
$3,308
Markup Ratio
7.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,307.95
Medicare Allowed$436.75
Medicare Payment$347.66

Hospitals charge 7.6x more than what Medicare allows for this procedure. Medicare actually pays $347.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$569$2,4051561,129+30.3%
California$564$4,1228349,053+29.2%
Virginia$549$3,5602532,610+25.7%
New Jersey$540$3,3572831,783+23.7%
Arizona$539$3,3552241,749+23.4%
District of Columbia$506$1,87233391+15.9%
Alabama$495$1,856124659+13.3%
Florida$492$3,1217674,957+12.6%
Mississippi$487$2,91580487+11.5%
Michigan$487$2,8833042,072+11.5%
Texas$481$3,1568724,300+10.2%
Massachusetts$472$3,3291771,471+8.1%
New York$457$4,7765523,994+4.5%
North Carolina$447$3,5152592,476+2.4%
Hawaii$441$1,88923163+1.1%
Georgia$422$4,2292821,251-3.3%
New Mexico$408$3,70840230-6.6%
Louisiana$404$3,737151814-7.6%
Arkansas$400$1,93992656-8.4%
Pennsylvania$389$3,2873793,109-10.9%
Colorado$367$2,621133835-15.9%
Connecticut$364$4,467107397-16.7%
Utah$362$2,27254362-17.2%
Delaware$346$1,74633211-20.9%
Missouri$344$3,1232021,265-21.2%
Nevada$342$2,98174374-21.8%
Tennessee$337$2,6002121,309-22.9%
South Dakota$325$1,43131245-25.6%
Iowa$318$4,22664460-27.2%
Illinois$315$3,1713812,111-27.8%
Kentucky$299$2,18591487-31.5%
Kansas$293$1,66572460-32.9%
South Carolina$285$2,613134833-34.7%
Oklahoma$268$1,606110562-38.6%
Alaska$268$5,0041591-38.7%
Washington$267$1,759168961-38.8%
Indiana$261$3,455166940-40.1%
Idaho$240$2,17346255-45.1%
Ohio$238$2,1202741,257-45.5%
Puerto Rico$226$5812068-48.3%
Minnesota$219$2,510131694-49.8%
Wisconsin$208$4,227167833-52.3%
Oregon$207$1,949101738-52.6%
Montana$205$1,73130181-53.1%
Maine$204$1,4522680-53.3%
West Virginia$199$1,23033209-54.5%
Rhode Island$197$3,64425141-55.0%
New Hampshire$195$3,16843162-55.4%
North Dakota$187$2,53926135-57.1%
Wyoming$185$1,198848-57.6%
Vermont$179$6,0021275-59.1%
Nebraska$174$3,91141365-60.2%

⚠️ 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