51703

Complicated insertion of bladder tube

Medicare pricing data for 10,042 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $68 in North Dakota to $155 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

Complicated insertion of bladder tube (HCPCS code 51703) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $121.63, but hospitals typically charge $397.41 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $121.63, your out-of-pocket cost would be approximately $24.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$121.63
Average Hospital Charge
$397.41
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$397.41
Medicare Allowed$121.63
Medicare Payment$93.54

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $93.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$155$60426197+27.4%
Puerto Rico$150$184914+23.1%
Hawaii$141$38025224+16.0%
California$140$4208605,872+14.8%
New York$134$5037935,226+10.4%
Massachusetts$134$4052841,901+10.3%
Connecticut$133$531167761+9.4%
Rhode Island$133$34049255+9.1%
Maryland$130$2902471,939+7.0%
Delaware$129$30338284+6.1%
New Jersey$128$5264483,314+5.5%
District of Columbia$128$36932154+5.2%
Florida$127$3287625,323+4.7%
Utah$121$28574251-0.7%
Illinois$120$5353811,561-1.0%
New Hampshire$120$32676569-1.7%
Arizona$118$3222351,071-3.0%
New Mexico$117$43331153-3.9%
Colorado$116$384175643-4.3%
Pennsylvania$116$3024661,582-4.5%
Kentucky$113$36681374-7.5%
Texas$112$3296062,581-7.6%
Alabama$112$224142558-7.6%
Ohio$112$3613591,683-7.9%
Virginia$112$347236813-8.3%
Oklahoma$111$307105427-9.1%
Missouri$110$496215738-9.3%
Mississippi$110$33174285-9.9%
Georgia$110$3873031,335-10.0%
Nevada$108$36677311-10.9%
North Carolina$108$3733861,561-10.9%
Maine$108$33038153-11.1%
Washington$106$313202689-12.8%
Tennessee$106$327198694-13.2%
Oregon$105$390112254-13.7%
South Carolina$104$341174589-14.1%
Indiana$104$364247923-14.3%
Wisconsin$104$899177587-14.5%
Louisiana$101$331128437-16.8%
Wyoming$101$3381440-16.9%
Michigan$100$290316903-18.1%
Arkansas$94$29563270-22.4%
Iowa$94$393117464-22.6%
Idaho$94$23742176-23.0%
Minnesota$90$531132263-26.3%
Nebraska$86$35462215-29.5%
Vermont$85$3932587-29.9%
Montana$84$2664498-30.7%
Kansas$83$29375193-31.9%
South Dakota$80$48445106-34.0%
West Virginia$78$28948125-35.9%
North Dakota$68$841941-44.0%

⚠️ 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