36415

Insertion of needle into vein for collection of blood sample

Medicare pricing data for 160,136 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 40.5 million services annually. Even small pricing inefficiencies here affect millions of patients. 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 needle into vein for collection of blood sample (HCPCS code 36415) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $8.18, but hospitals typically charge $19.17 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.64

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $8.18, your out-of-pocket cost would be approximately $1.64. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$8.18
Average Hospital Charge
$19.17
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$19.17
Medicare Allowed$8.18
Medicare Payment$8.18

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $8.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$8$1516059,842+2.6%
Massachusetts$8$233,7701,188,774+1.8%
Wisconsin$8$274,874638,565+1.8%
Georgia$8$225,0691,166,061+1.7%
North Carolina$8$226,2632,709,153+1.7%
North Dakota$8$1953584,547+1.7%
Indiana$8$143,293475,102+1.6%
Vermont$8$1930726,640+1.5%
Minnesota$8$206,297641,558+1.3%
Nevada$8$23672286,892+1.2%
Ohio$8$173,7581,251,831+1.2%
Maryland$8$202,341739,521+1.1%
Tennessee$8$175,8151,291,776+1.0%
Alaska$8$3756031,231+1.0%
California$8$219,3724,084,185+1.0%
Iowa$8$142,452425,528+0.9%
Connecticut$8$181,072116,815+0.7%
New Jersey$8$243,7862,973,431+0.6%
Pennsylvania$8$204,814928,111+0.6%
Kansas$8$221,788837,880+0.5%
New Mexico$8$15734130,912+0.5%
Illinois$8$218,0861,373,806+0.1%
Texas$8$1811,5103,439,255+0.1%
West Virginia$8$1784469,886+0.1%
New York$8$1913,7652,276,3230.0%
Arizona$8$162,8591,457,319-0.2%
Maine$8$1151266,909-0.4%
Missouri$8$172,971367,878-0.4%
Colorado$8$202,248368,669-0.5%
Mississippi$8$192,501482,168-0.6%
Hawaii$8$9101228,807-0.7%
Idaho$8$141,07779,697-0.9%
Kentucky$8$152,153224,922-0.9%
Washington$8$193,751832,955-0.9%
District of Columbia$8$1430917,843-1.0%
Florida$8$1911,1093,722,032-1.0%
Utah$8$131,697176,507-1.1%
South Carolina$8$163,494709,976-1.6%
Arkansas$8$132,269419,273-1.7%
Louisiana$8$131,471323,734-2.1%
Oregon$8$142,256322,218-2.4%
Virginia$8$164,672987,133-2.4%
Alabama$8$182,539939,075-2.4%
Montana$8$1364160,442-3.2%
Wyoming$8$1839842,371-3.2%
Michigan$8$123,600391,176-4.6%
Oklahoma$8$131,851453,009-5.4%
Delaware$8$1410824,117-7.0%
New Hampshire$8$1545535,182-7.5%
South Dakota$8$1462186,132-8.1%
Nebraska$7$121,835300,761-8.8%
Puerto Rico$6$761178,132-24.2%

⚠️ 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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