36558

Insertion of tunneled central venous tube for infusion (5 years or older)

Medicare pricing data for 10,961 providers across 52 states

🤖AI Overview

This procedure has a 6.5x markup — hospitals charge $1,893 but Medicare allows only $290.11. Uninsured patients may face bills 6.5 times higher than what insurance negotiates. Prices vary significantly by location — from $226 in Oklahoma to $463 in Rhode Island. 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 tunneled central venous tube for infusion (5 years or older) (HCPCS code 36558) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $290.11, but hospitals typically charge $1,893 — a 6.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$58.02

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $290.11, your out-of-pocket cost would be approximately $58.02. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$290.11
Average Hospital Charge
$1,893
Markup Ratio
6.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,893.43
Medicare Allowed$290.11
Medicare Payment$230.24

Hospitals charge 6.5x more than what Medicare allows for this procedure. Medicare actually pays $230.24 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$463$2,36440259+59.8%
Nevada$378$2,69890875+30.3%
Maryland$346$1,2842142,614+19.1%
Delaware$329$98943586+13.3%
New Jersey$324$2,0323182,619+11.8%
California$323$1,9971,0438,963+11.3%
Kansas$320$1,336112947+10.4%
New York$313$2,6166874,974+7.9%
Virginia$312$1,5203042,949+7.7%
Alaska$311$2,85226234+7.2%
Arizona$310$2,7922071,628+6.7%
Puerto Rico$306$99352185+5.4%
Texas$303$1,9128767,398+4.5%
Connecticut$302$2,199129848+4.1%
Georgia$297$2,3253702,880+2.3%
Alabama$297$1,4051851,358+2.3%
Illinois$295$2,2484304,496+1.5%
North Carolina$293$1,7963232,840+1.0%
District of Columbia$292$1,21436427+0.6%
Michigan$280$1,1813562,826-3.4%
New Mexico$279$1,58763488-3.9%
Ohio$278$1,8164053,391-4.1%
Pennsylvania$277$1,4134734,423-4.5%
Oregon$276$1,341142801-4.7%
Florida$276$2,1668187,166-4.8%
Mississippi$276$2,0071121,117-5.0%
Indiana$275$1,8322291,927-5.2%
Minnesota$275$2,2791581,682-5.3%
South Carolina$274$1,9131721,426-5.5%
Louisiana$273$1,6671781,306-5.9%
Massachusetts$266$1,9342662,137-8.4%
Colorado$263$1,427156974-9.2%
Tennessee$262$1,6222522,200-9.5%
South Dakota$261$1,69342373-10.1%
Utah$259$1,33384505-10.6%
Washington$256$1,4152001,626-11.7%
Nebraska$248$1,98766522-14.6%
Arkansas$247$1,478113891-14.9%
New Hampshire$246$1,76755369-15.2%
Vermont$245$4,4001383-15.5%
Wisconsin$244$3,4572031,680-15.9%
Kentucky$244$1,1861721,308-16.0%
Montana$243$1,17036161-16.2%
Wyoming$242$2,4551084-16.6%
Missouri$241$1,5292181,929-17.1%
North Dakota$239$3,53825296-17.5%
Iowa$239$1,84981633-17.7%
Hawaii$233$1,07443235-19.6%
West Virginia$233$1,17064427-19.8%
Maine$230$1,17849209-20.8%
Idaho$228$1,57655386-21.4%
Oklahoma$226$1,0481221,356-22.2%

⚠️ 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