52281

Dilation of urethra using an endoscope

Medicare pricing data for 9,167 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $144 in North Dakota to $431 in Maryland. 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

Dilation of urethra using an endoscope (HCPCS code 52281) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $321.52, but hospitals typically charge $1,289 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$64.30

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $321.52, your out-of-pocket cost would be approximately $64.30. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$321.52
Average Hospital Charge
$1,289
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,288.53
Medicare Allowed$321.52
Medicare Payment$250.21

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $250.21 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$431$1,7191841,376+34.0%
Colorado$372$2,204164813+15.8%
New Jersey$370$2,0743653,575+15.0%
California$370$1,1087447,932+14.9%
Nebraska$362$1,43252250+12.6%
Mississippi$358$2,132811,046+11.3%
Delaware$348$1,23140197+8.2%
Florida$346$1,2908156,217+7.5%
New York$345$1,1605893,447+7.2%
Georgia$344$1,6092741,816+7.1%
Arizona$331$1,2582471,584+3.0%
Pennsylvania$325$9824051,579+1.1%
Hawaii$324$1,02623114+0.8%
Puerto Rico$324$3611944+0.7%
Oregon$317$1,204103303-1.4%
Nevada$313$88055320-2.6%
Massachusetts$309$1,2312331,147-3.8%
Tennessee$305$1,0452151,145-5.0%
Virginia$301$1,191235826-6.5%
Kansas$299$1,24986341-7.1%
Alaska$297$3,6962042-7.6%
Ohio$297$1,0173421,990-7.6%
South Carolina$292$1,1571661,085-9.3%
Washington$289$936171578-10.1%
Louisiana$288$1,3461461,098-10.3%
South Dakota$280$1,33822156-12.9%
Connecticut$279$1,460101295-13.3%
Texas$276$1,3215562,073-14.3%
Michigan$275$7932871,166-14.4%
Kentucky$268$1,08790536-16.6%
Idaho$265$6944295-17.5%
Arkansas$263$86970384-18.2%
Indiana$262$1,973257792-18.6%
Missouri$261$1,110183663-19.0%
Rhode Island$260$7653191-19.0%
Illinois$260$1,1394262,801-19.1%
Wyoming$256$1,0301967-20.3%
Alabama$254$920125517-21.0%
Utah$247$81774246-23.3%
North Carolina$245$992304872-23.9%
Minnesota$238$1,392155378-25.9%
New Mexico$231$8903588-28.3%
Oklahoma$229$698124640-28.7%
Iowa$222$1,17589268-30.9%
District of Columbia$220$9002993-31.7%
Montana$205$58239142-36.2%
Wisconsin$202$1,874158388-37.1%
New Hampshire$191$1,2344496-40.6%
Vermont$161$7662253-50.1%
West Virginia$157$1,07043174-51.2%
Maine$157$6223786-51.2%
North Dakota$144$1,7011170-55.3%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber