51736

Simple timed assessment of bladder emptying

Medicare pricing data for 651 providers across 41 states

🤖AI Overview

This procedure has a 11.0x markup — hospitals charge $123.22 but Medicare allows only $11.23. Uninsured patients may face bills 11.0 times higher than what insurance negotiates. Prices vary significantly by location — from $3 in Minnesota to $15 in Maryland. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Simple timed assessment of bladder emptying (HCPCS code 51736) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.23, but hospitals typically charge $123.22 — a 11.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.23, your out-of-pocket cost would be approximately $2.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.23
Average Hospital Charge
$123.22
Markup Ratio
11.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$123.22
Medicare Allowed$11.23
Medicare Payment$8.30

Hospitals charge 11.0x more than what Medicare allows for this procedure. Medicare actually pays $8.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$15$1209439+30.6%
Washington$14$5222109+23.2%
New Jersey$14$5714102+23.0%
Puerto Rico$13$119215+19.3%
California$13$184821,032+14.0%
New York$13$13848347+13.3%
Florida$13$106591,346+11.4%
Colorado$12$9212328+10.6%
Virginia$12$114611+9.3%
Kentucky$12$1437127+3.6%
Missouri$12$17913141+3.4%
Connecticut$12$757164+3.1%
Pennsylvania$11$15634162+2.3%
North Carolina$11$17441240-1.8%
Nebraska$11$9115207-3.3%
Wisconsin$11$211832-6.0%
Ohio$10$791766-7.5%
Alabama$10$62723-9.1%
Delaware$10$69514-11.0%
Montana$10$34390-11.5%
Massachusetts$10$17019153-12.1%
Oklahoma$9$521372-15.9%
Texas$9$8037161-16.0%
Michigan$9$501372-21.0%
Oregon$9$58950-23.3%
South Dakota$8$91439-27.9%
Tennessee$8$15019640-28.4%
Arizona$8$7220156-29.2%
Mississippi$8$82515-31.0%
Arkansas$8$691061-31.0%
New Hampshire$7$109418-34.6%
Illinois$7$17020142-34.8%
Hawaii$7$25312-35.0%
Indiana$7$371364-39.4%
South Carolina$7$9110128-40.6%
Utah$7$80535-41.0%
Georgia$6$67420-43.4%
Maine$5$25831-52.8%
New Mexico$4$89317-62.8%
Idaho$4$20319-66.2%
Minnesota$3$26421-72.8%

⚠️ 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