46600

Diagnostic exam of anus using an endoscope

Medicare pricing data for 7,598 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $45 in Vermont to $135 in New Jersey. 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

Diagnostic exam of anus using an endoscope (HCPCS code 46600) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $111.44, but hospitals typically charge $297.77 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$22.29

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $111.44, your out-of-pocket cost would be approximately $22.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$111.44
Average Hospital Charge
$297.77
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$297.77
Medicare Allowed$111.44
Medicare Payment$83.02

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $83.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$135$4531684,233+21.0%
New York$131$4144469,716+17.8%
Maryland$130$2701531,899+16.6%
Alaska$128$39528217+14.6%
California$127$2951,17211,587+13.7%
Connecticut$125$4131051,283+12.2%
District of Columbia$122$27622615+9.5%
Puerto Rico$121$2891159+8.4%
Colorado$119$2841801,095+6.8%
Wyoming$118$170747+6.2%
Virginia$118$2592242,768+5.6%
Nevada$117$24148583+4.7%
Florida$114$2844397,767+2.4%
Georgia$113$3021632,161+1.6%
Texas$112$2933986,765+0.5%
Washington$112$2992561,636+0.3%
Oregon$109$3141541,061-2.1%
Indiana$108$2271141,687-3.1%
South Dakota$107$18732132-3.9%
Arizona$107$2421643,603-4.1%
South Carolina$107$2401081,385-4.3%
Massachusetts$105$3702233,776-5.4%
Pennsylvania$105$2143244,124-5.5%
Rhode Island$102$34720256-8.3%
Missouri$102$2381161,320-8.8%
Oklahoma$101$18648549-9.2%
Hawaii$100$1982595-9.9%
North Carolina$99$2632952,267-11.0%
Minnesota$99$4241851,476-11.6%
Alabama$98$17954415-11.9%
Arkansas$98$19234443-12.3%
Utah$96$22680526-13.6%
Kansas$96$22070809-13.9%
Iowa$96$284118589-13.9%
Tennessee$95$304991,673-14.5%
Nebraska$95$27496853-15.1%
Delaware$94$21313357-15.8%
Michigan$93$1912142,036-16.5%
Illinois$91$2632673,613-18.2%
Kentucky$91$20754480-18.6%
Montana$88$22247244-21.1%
Wisconsin$85$4032351,009-23.6%
West Virginia$85$30120164-24.1%
Louisiana$80$17560758-28.2%
Ohio$80$2132192,515-28.6%
Mississippi$78$22930136-30.2%
New Mexico$77$18450298-30.6%
New Hampshire$76$26851553-31.8%
North Dakota$70$15338157-37.6%
Idaho$54$16054343-51.4%
Maine$46$14034263-58.9%
Vermont$45$9326191-59.2%

⚠️ 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