50590

Shock wave crushing of kidney stones

Medicare pricing data for 5,427 providers across 50 states

🤖AI Overview

This procedure has a 6.0x markup — hospitals charge $4,212 but Medicare allows only $701.92. Uninsured patients may face bills 6.0 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

Shock wave crushing of kidney stones (HCPCS code 50590) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $701.92, but hospitals typically charge $4,212 — a 6.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$140.38

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $701.92, your out-of-pocket cost would be approximately $140.38. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$701.92
Average Hospital Charge
$4,212
Markup Ratio
6.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$4,211.55
Medicare Allowed$701.92
Medicare Payment$555.56

Hospitals charge 6.0x more than what Medicare allows for this procedure. Medicare actually pays $555.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$973$5,080701,285+38.6%
Delaware$917$5,06322566+30.6%
California$852$5,1944743,427+21.4%
New Jersey$828$6,9462512,537+18.0%
Massachusetts$803$3,9951201,323+14.4%
Colorado$789$6,66991724+12.4%
Hawaii$786$3,399933+12.0%
New York$783$4,5773121,587+11.6%
Florida$756$6,0384964,047+7.6%
Connecticut$749$5,14765360+6.7%
Virginia$746$3,5541211,098+6.3%
Alaska$745$9,2071252+6.1%
Rhode Island$736$2,67715104+4.8%
New Hampshire$734$4,30225130+4.6%
Illinois$727$4,2311971,808+3.5%
Georgia$723$4,4931861,660+3.0%
Pennsylvania$721$3,1661981,517+2.7%
Oregon$704$3,11843146+0.2%
Ohio$703$3,7912102,012+0.2%
Utah$702$4,83547620+0.0%
Missouri$696$5,4341271,330-0.9%
Iowa$687$3,89358486-2.2%
Puerto Rico$678$1,1093292-3.4%
Texas$655$4,0663962,624-6.8%
Nebraska$654$3,67039443-6.8%
Kansas$646$3,86853554-7.9%
Michigan$643$2,180145903-8.4%
Montana$638$3,16526201-9.1%
Indiana$638$5,0151471,617-9.2%
Arizona$620$3,0901401,828-11.6%
South Carolina$604$3,402901,360-13.9%
Tennessee$599$3,0791401,247-14.7%
Washington$597$2,125111874-15.0%
New Mexico$591$2,98516123-15.8%
Mississippi$591$3,705631,491-15.9%
Nevada$580$2,57921243-17.4%
Wisconsin$577$8,08677400-17.8%
Minnesota$569$2,37449151-18.9%
North Carolina$566$1,9321921,135-19.4%
Wyoming$549$4,470736-21.8%
North Dakota$547$3,1461024-22.1%
Kentucky$545$2,01850519-22.4%
Vermont$544$2,6641156-22.5%
West Virginia$543$1,96625226-22.6%
Louisiana$538$2,45499758-23.3%
South Dakota$536$2,2911899-23.6%
Oklahoma$535$1,501801,111-23.8%
Alabama$529$2,02388767-24.7%
Idaho$527$1,31429178-25.0%
Arkansas$522$1,78746547-25.7%

⚠️ 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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