38222

Biopsy and aspiration of bone marrow sample for diagnosis

Medicare pricing data for 12,928 providers across 52 states

🤖AI Overview

This procedure has a 6.3x markup — hospitals charge $620.73 but Medicare allows only $99.21. Uninsured patients may face bills 6.3 times higher than what insurance negotiates. Prices vary significantly by location — from $65 in Idaho to $229 in Arizona. 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

Biopsy and aspiration of bone marrow sample for diagnosis (HCPCS code 38222) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $99.21, but hospitals typically charge $620.73 — a 6.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$19.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $99.21, your out-of-pocket cost would be approximately $19.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$99.21
Average Hospital Charge
$620.73
Markup Ratio
6.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$620.73
Medicare Allowed$99.21
Medicare Payment$77.13

Hospitals charge 6.3x more than what Medicare allows for this procedure. Medicare actually pays $77.13 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$229$1,2692312,901+130.8%
Nebraska$157$6481221,245+58.4%
Alaska$156$1,20828203+57.4%
New Jersey$128$5823842,424+28.9%
Kansas$127$1,4891352,021+28.1%
Kentucky$116$5521641,426+17.4%
Hawaii$115$32236163+15.4%
Nevada$112$611116941+12.6%
Arkansas$109$6121043,175+10.3%
New York$109$7298967,409+10.1%
Maryland$106$3792012,335+7.2%
Puerto Rico$106$1,05731105+6.6%
Texas$105$73889011,591+5.7%
California$105$5711,10811,251+5.6%
Missouri$105$5542782,856+5.4%
Minnesota$104$6822101,782+5.0%
Florida$98$58892310,160-0.8%
Illinois$98$5215875,017-1.1%
Delaware$96$32931274-3.7%
Colorado$94$1,7352582,249-5.1%
Connecticut$93$6752151,271-5.9%
Virginia$91$4633503,678-8.1%
Oregon$90$4751981,443-9.8%
Washington$89$4033052,465-10.0%
Louisiana$89$6031531,377-10.0%
Alabama$87$4001731,166-12.0%
New Mexico$87$43773447-12.1%
Tennessee$86$4792593,247-13.2%
Wyoming$85$52223110-14.1%
Indiana$84$4162602,338-15.0%
Maine$84$34975313-15.4%
Iowa$83$6211401,319-16.1%
District of Columbia$83$38636372-16.7%
Michigan$83$3143562,808-16.8%
Utah$83$403126872-16.8%
Georgia$82$6893624,121-17.2%
Massachusetts$81$4423312,205-17.9%
Pennsylvania$81$3696704,826-18.0%
Rhode Island$81$39944157-18.0%
South Carolina$81$4851881,914-18.3%
Ohio$80$4715204,162-18.9%
New Hampshire$80$69579518-19.0%
Oklahoma$80$3951041,437-19.2%
South Dakota$80$31235556-19.3%
West Virginia$80$29172588-19.7%
Montana$76$85744376-23.0%
North Carolina$74$4995193,830-25.2%
Wisconsin$73$1,0562812,230-26.2%
Mississippi$72$661691,003-27.7%
North Dakota$69$86326366-30.7%
Vermont$67$41821266-33.0%
Idaho$65$39375529-34.3%

⚠️ 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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