37221

Insertion of stent in groin artery, initial vessel

Medicare pricing data for 6,209 providers across 51 states

🤖AI Overview

This procedure has a 7.6x markup — hospitals charge $7,206 but Medicare allows only $946.71. Uninsured patients may face bills 7.6 times higher than what insurance negotiates. Prices vary significantly by location — from $334 in Utah to $1,803 in Alaska. 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 stent in groin artery, initial vessel (HCPCS code 37221) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $946.71, but hospitals typically charge $7,206 — a 7.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$189.34

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $946.71, your out-of-pocket cost would be approximately $189.34. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$946.71
Average Hospital Charge
$7,206
Markup Ratio
7.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$7,206.42
Medicare Allowed$946.71
Medicare Payment$753.48

Hospitals charge 7.6x more than what Medicare allows for this procedure. Medicare actually pays $753.48 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$1,803$28,4671343+90.5%
Hawaii$1,802$6,8461655+90.3%
Maryland$1,614$6,492106487+70.5%
Arizona$1,414$6,624192551+49.4%
Connecticut$1,354$10,77277209+43.0%
Delaware$1,339$6,3802891+41.5%
Florida$1,257$6,2185922,051+32.7%
New Jersey$1,249$10,569192597+31.9%
California$1,240$10,1754801,426+31.0%
Michigan$1,167$4,545242677+23.3%
Alabama$1,124$6,453107324+18.7%
Oregon$1,123$5,41372266+18.6%
Nevada$1,106$6,15546122+16.8%
Georgia$1,085$11,656183571+14.6%
Tennessee$1,077$7,039185761+13.7%
Louisiana$1,042$9,171141371+10.1%
Texas$984$7,9435591,587+3.9%
South Dakota$981$5,12929230+3.6%
Kansas$976$7,54353261+3.1%
New York$944$10,809317993-0.2%
Virginia$935$5,120148460-1.3%
Mississippi$914$9,11863239-3.5%
Massachusetts$883$6,234127452-6.8%
Nebraska$793$9,78034207-16.2%
Kentucky$748$3,13895403-21.0%
Colorado$733$5,10567194-22.6%
North Carolina$724$6,522167553-23.5%
South Carolina$709$10,295114420-25.1%
Illinois$703$8,174249782-25.7%
Arkansas$679$2,78883341-28.3%
Iowa$670$9,99455209-29.2%
Oklahoma$630$3,37878309-33.5%
Pennsylvania$609$4,339254780-35.6%
Washington$600$3,36287344-36.6%
Missouri$561$5,584123475-40.7%
District of Columbia$526$3,391741-44.4%
Wisconsin$516$11,553134386-45.5%
Indiana$513$6,113132419-45.8%
Ohio$513$3,797186603-45.8%
Wyoming$458$3,348932-51.6%
West Virginia$440$5,49240168-53.5%
Montana$439$2,68328104-53.6%
Rhode Island$424$4,8861865-55.2%
New Mexico$406$6,6131742-57.1%
Vermont$406$21,047517-57.2%
North Dakota$399$5,5482277-57.9%
Maine$380$2,9902278-59.8%
Idaho$379$3,51830135-59.9%
Minnesota$378$6,09392333-60.0%
New Hampshire$372$10,24538113-60.7%
Utah$334$2,5852348-64.7%

⚠️ 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