47490

Insertion of tube into gallbladder using imaging guidance with review by radiologist

Medicare pricing data for 4,359 providers across 51 states

🤖AI Overview

This procedure has a 5.2x markup — hospitals charge $1,726 but Medicare allows only $331.25. Uninsured patients may face bills 5.2 times higher than what insurance negotiates. 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 into gallbladder using imaging guidance with review by radiologist (HCPCS code 47490) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $331.25, but hospitals typically charge $1,726 — a 5.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$66.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $331.25, your out-of-pocket cost would be approximately $66.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$331.25
Average Hospital Charge
$1,726
Markup Ratio
5.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,726.33
Medicare Allowed$331.25
Medicare Payment$262.74

Hospitals charge 5.2x more than what Medicare allows for this procedure. Medicare actually pays $262.74 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$406$2,706817+22.5%
District of Columbia$359$1,4152180+8.5%
New York$359$1,887271859+8.4%
New Jersey$357$1,814134442+7.9%
California$354$1,6904171,048+6.9%
Massachusetts$349$1,468132362+5.4%
Maryland$348$1,27477282+5.1%
Connecticut$347$1,59970205+4.7%
Hawaii$346$1,0121131+4.3%
Rhode Island$340$1,4092357+2.6%
Washington$339$1,28996271+2.4%
Colorado$338$1,65173151+2.2%
Illinois$337$1,860179607+1.8%
Vermont$335$2,1781127+1.0%
Pennsylvania$333$1,522233783+0.4%
Montana$333$1,3551215+0.4%
Delaware$333$9851982+0.4%
Florida$332$2,122310799+0.2%
Virginia$329$1,526131372-0.7%
Oregon$328$1,18155139-1.0%
New Mexico$325$1,8092166-1.9%
Nevada$325$2,1904086-2.0%
Michigan$324$1,199130366-2.1%
New Hampshire$324$2,1582779-2.1%
Minnesota$323$1,56971173-2.4%
Texas$322$2,046296765-2.8%
Wyoming$321$1,523813-3.0%
South Dakota$321$1,3691144-3.2%
North Dakota$319$1,6121131-3.7%
Georgia$317$1,681122239-4.2%
Missouri$317$1,59599253-4.3%
Maine$316$1,2742235-4.6%
North Carolina$316$1,922146384-4.6%
Ohio$316$1,909174409-4.7%
Louisiana$315$1,59051129-4.8%
Wisconsin$314$3,172106260-5.2%
Arizona$314$2,62278177-5.3%
Kentucky$313$1,36656132-5.6%
South Carolina$313$1,70168168-5.7%
Kansas$309$1,0714193-6.6%
Alabama$309$1,05759112-6.7%
Utah$308$1,3452752-6.9%
Idaho$307$1,5322667-7.3%
Iowa$307$1,36638105-7.4%
Nebraska$306$1,50227121-7.5%
Oklahoma$306$1,17644111-7.6%
Indiana$304$1,47586220-8.2%
Tennessee$303$1,74493240-8.4%
Mississippi$300$1,1454099-9.3%
Arkansas$298$2,04030104-9.9%
West Virginia$298$1,4982359-10.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber