51720

Instillation of anti-cancer drug into bladder

Medicare pricing data for 9,330 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $35 in Vermont to $99 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

Instillation of anti-cancer drug into bladder (HCPCS code 51720) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $78.72, but hospitals typically charge $392.16 — a 5.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $78.72, your out-of-pocket cost would be approximately $15.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$78.72
Average Hospital Charge
$392.16
Markup Ratio
5.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$392.16
Medicare Allowed$78.72
Medicare Payment$60.79

Hospitals charge 5.0x more than what Medicare allows for this procedure. Medicare actually pays $60.79 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$99$2,27020236+26.0%
New Jersey$93$8963155,765+17.6%
Connecticut$88$4281391,952+11.9%
California$87$36875313,546+10.2%
New York$86$49058710,667+9.8%
Maryland$85$3662515,012+7.4%
Puerto Rico$84$25114144+7.3%
Massachusetts$84$4362705,587+6.7%
Virginia$83$3002265,209+5.2%
Florida$82$34174515,453+4.6%
Minnesota$82$4761691,759+3.6%
District of Columbia$81$30830723+2.8%
Illinois$81$7153797,616+2.7%
Rhode Island$81$22547680+2.4%
Pennsylvania$81$3023826,560+2.4%
Nevada$79$303701,225+0.5%
Georgia$79$3172624,103+0.5%
Oregon$79$2981231,785+0.4%
Arizona$78$4392684,615-0.6%
Indiana$78$3142003,569-1.3%
Texas$78$3066419,896-1.4%
Wyoming$77$30618225-1.9%
Colorado$76$3252012,601-3.2%
Missouri$75$3382253,007-4.2%
Nebraska$75$300771,155-4.7%
Delaware$75$296441,185-4.8%
Louisiana$74$2621211,837-5.7%
Hawaii$74$23816119-6.1%
Mississippi$74$389651,253-6.3%
North Carolina$74$3113014,580-6.5%
Kansas$73$312931,330-6.7%
Washington$73$2522233,530-7.0%
Michigan$73$2672713,944-7.1%
Arkansas$73$284911,496-7.5%
Alabama$72$2461141,677-8.1%
South Carolina$72$3221763,383-8.2%
South Dakota$72$43638710-8.5%
Oklahoma$72$2411042,257-8.7%
Ohio$71$3032453,107-9.2%
New Hampshire$70$36151762-10.8%
Utah$70$25766867-11.2%
Maine$69$25345367-12.0%
Wisconsin$68$1,0391931,988-13.5%
Tennessee$67$3152163,904-15.4%
New Mexico$65$26231472-16.9%
Kentucky$63$298901,207-19.8%
Montana$60$19549763-23.2%
Idaho$58$170581,005-26.2%
Iowa$52$4331193,007-34.0%
West Virginia$49$22338520-37.9%
North Dakota$44$30928312-44.7%
Vermont$35$22814110-55.1%

⚠️ 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