36573

Insertion of tube for infusion with imaging guidance and review by radiologist, patient 5 years or older

Medicare pricing data for 6,147 providers across 52 states

🤖AI Overview

This procedure has a 7.0x markup — hospitals charge $681.70 but Medicare allows only $96.74. Uninsured patients may face bills 7.0 times higher than what insurance negotiates. Prices vary significantly by location — from $72 in Idaho to $152 in Florida. 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 for infusion with imaging guidance and review by radiologist, patient 5 years or older (HCPCS code 36573) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $96.74, but hospitals typically charge $681.70 — a 7.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$19.35

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $96.74, your out-of-pocket cost would be approximately $19.35. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$96.74
Average Hospital Charge
$681.70
Markup Ratio
7.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$681.70
Medicare Allowed$96.74
Medicare Payment$76.18

Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $76.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$152$9204123,176+57.2%
Wyoming$151$1,07516134+56.2%
Texas$151$7373681,959+56.1%
Oregon$137$66642125+41.6%
New Mexico$133$7463375+37.8%
Georgia$123$6791581,092+26.9%
Oklahoma$110$58746254+14.0%
California$108$6804815,319+12.0%
Rhode Island$103$53332296+6.1%
Alaska$101$968723+4.8%
New York$101$8965234,362+4.4%
Arkansas$101$82045274+3.9%
Nebraska$99$56334175+2.1%
Colorado$98$65597458+1.4%
Alabama$97$43695735+0.8%
Utah$94$53352187-2.9%
Arizona$92$1,031104356-5.0%
Illinois$91$9652551,969-6.4%
Massachusetts$90$6542121,826-6.5%
New Jersey$90$6032033,137-7.0%
Maryland$88$32285702-9.2%
Connecticut$87$6921171,251-9.8%
Michigan$87$3642131,448-9.9%
District of Columbia$87$37829109-10.1%
Vermont$86$1,2771065-11.4%
Minnesota$85$567140677-11.8%
Montana$83$40113180-14.6%
Virginia$82$5162072,878-14.8%
Puerto Rico$82$128421-14.8%
Delaware$82$3011869-14.9%
Pennsylvania$82$4243092,479-14.9%
New Hampshire$82$36733273-15.1%
Hawaii$82$4961772-15.4%
Nevada$81$53438292-15.8%
Maine$80$42325198-17.2%
Kansas$79$27339250-18.1%
North Dakota$79$1,09328139-18.6%
Indiana$79$733150929-18.6%
Missouri$79$564133975-18.6%
South Dakota$79$52928232-18.7%
Washington$78$31373481-19.5%
Tennessee$78$33773298-19.9%
Ohio$77$7251821,122-20.9%
Iowa$77$54481502-20.9%
Wisconsin$76$1,4192081,701-21.4%
Louisiana$76$53865365-21.8%
North Carolina$75$6112351,837-22.0%
West Virginia$75$35141477-22.0%
Mississippi$75$648561,073-22.4%
South Carolina$75$59187754-22.8%
Kentucky$74$55775485-23.4%
Idaho$72$41869692-25.3%

⚠️ 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