36905

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube

Medicare pricing data for 4,028 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $399 in Iowa to $3,066 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

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube (HCPCS code 36905) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,956, but hospitals typically charge $6,358 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$391.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,956, your out-of-pocket cost would be approximately $391.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,956
Average Hospital Charge
$6,358
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$6,358.01
Medicare Allowed$1,956.31
Medicare Payment$1,555.65

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $1,556 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$3,066$10,8294133+56.7%
Nevada$2,759$9,27733296+41.0%
New Jersey$2,625$8,7511351,090+34.2%
Kansas$2,530$5,63425240+29.4%
Maryland$2,498$5,72282894+27.7%
Arizona$2,336$6,79066378+19.4%
Virginia$2,330$7,2581221,053+19.1%
Pennsylvania$2,303$7,995165934+17.7%
New York$2,276$7,0632381,566+16.3%
Texas$2,218$6,8302962,624+13.4%
Alabama$2,204$6,58557447+12.7%
Puerto Rico$2,083$4,6741498+6.5%
Ohio$2,074$7,225106478+6.0%
Connecticut$2,074$6,40541199+6.0%
California$2,057$6,5925083,137+5.2%
Illinois$1,929$5,9282051,079-1.4%
Oregon$1,923$4,12644133-1.7%
Tennessee$1,901$6,54970454-2.8%
North Carolina$1,865$6,888122626-4.7%
Delaware$1,823$3,18522144-6.8%
Georgia$1,819$7,550164798-7.0%
Michigan$1,796$5,566122714-8.2%
Florida$1,761$5,7523211,562-10.0%
Indiana$1,742$5,98272367-11.0%
Minnesota$1,503$4,33769208-23.2%
Utah$1,334$4,2973197-31.8%
Mississippi$1,298$5,98839402-33.7%
Arkansas$1,279$3,29941191-34.6%
District of Columbia$1,276$5,0961470-34.8%
Louisiana$1,252$4,98370444-36.0%
Washington$1,244$3,80370235-36.4%
South Carolina$1,198$4,63374458-38.7%
Wisconsin$1,121$7,01482234-42.7%
Nebraska$1,100$6,2701853-43.8%
Colorado$1,067$4,13162160-45.5%
Missouri$949$4,25792336-51.5%
New Mexico$881$3,7132160-55.0%
Kentucky$818$3,12039203-58.2%
Massachusetts$767$2,73466214-60.8%
Alaska$575$8,059543-70.6%
Oklahoma$446$2,19544168-77.2%
Hawaii$430$1,099750-78.0%
West Virginia$421$1,5071629-78.5%
North Dakota$414$2,2571463-78.8%
Maine$410$1,5211123-79.0%
Idaho$408$1,7361747-79.1%
South Dakota$408$2,1911240-79.2%
Wyoming$405$2,093614-79.3%
New Hampshire$402$2,6531018-79.5%
Iowa$399$4,5782973-79.6%

⚠️ 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