Insertion of implant in urethra within prostate gland using an endoscope, each additional implant
Medicare pricing data for 3,041 providers across 51 states
This procedure has a 6.3x markup — hospitals charge $1,906 but Medicare allows only $304.39. Uninsured patients may face bills 6.3 times higher than what insurance negotiates. Prices vary significantly by location — from $45 in Arkansas to $891 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
Insertion of implant in urethra within prostate gland using an endoscope, each additional implant (HCPCS code 52442) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $304.39, but hospitals typically charge $1,906 — a 6.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $304.39, your out-of-pocket cost would be approximately $60.88. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 6.3x more than what Medicare allows for this procedure. Medicare actually pays $242.88 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $891 | $4,385 | 2 | 157 | +192.6% |
| California | $628 | $2,228 | 283 | 7,751 | +106.3% |
| New Jersey | $563 | $4,847 | 126 | 3,369 | +85.1% |
| Nevada | $528 | $2,285 | 21 | 301 | +73.3% |
| New York | $509 | $2,910 | 191 | 3,191 | +67.3% |
| Connecticut | $508 | $2,195 | 22 | 439 | +67.0% |
| Iowa | $504 | $2,126 | 43 | 955 | +65.7% |
| Illinois | $489 | $2,674 | 98 | 2,697 | +60.5% |
| Utah | $451 | $1,698 | 15 | 380 | +48.2% |
| Texas | $430 | $1,722 | 195 | 4,970 | +41.1% |
| Arizona | $405 | $1,936 | 125 | 3,592 | +33.1% |
| Oregon | $404 | $2,238 | 36 | 991 | +32.8% |
| Michigan | $381 | $1,224 | 96 | 2,159 | +25.2% |
| New Hampshire | $373 | $1,135 | 12 | 471 | +22.7% |
| Wisconsin | $369 | $4,900 | 46 | 797 | +21.2% |
| North Carolina | $359 | $1,800 | 96 | 2,277 | +17.9% |
| Minnesota | $355 | $3,004 | 28 | 278 | +16.6% |
| Washington | $330 | $1,225 | 55 | 2,291 | +8.3% |
| Louisiana | $322 | $1,811 | 49 | 1,260 | +5.7% |
| Tennessee | $267 | $1,708 | 106 | 2,506 | -12.4% |
| Indiana | $256 | $2,265 | 71 | 1,841 | -16.0% |
| Colorado | $243 | $2,309 | 45 | 1,517 | -20.1% |
| Delaware | $238 | $1,118 | 15 | 313 | -21.8% |
| Massachusetts | $231 | $1,617 | 55 | 948 | -24.0% |
| South Carolina | $180 | $1,541 | 61 | 2,165 | -40.9% |
| Nebraska | $176 | $823 | 32 | 981 | -42.0% |
| Kansas | $153 | $1,469 | 34 | 751 | -49.7% |
| Georgia | $142 | $1,179 | 121 | 2,858 | -53.3% |
| Ohio | $138 | $1,165 | 129 | 3,000 | -54.7% |
| Florida | $130 | $1,218 | 239 | 6,773 | -57.2% |
| Missouri | $118 | $1,420 | 68 | 1,271 | -61.1% |
| Oklahoma | $111 | $525 | 31 | 936 | -63.7% |
| Kentucky | $103 | $856 | 40 | 781 | -66.2% |
| Virginia | $84 | $803 | 53 | 2,099 | -72.4% |
| Pennsylvania | $76 | $1,295 | 129 | 3,159 | -75.1% |
| Mississippi | $70 | $1,751 | 39 | 1,572 | -77.0% |
| District of Columbia | $55 | $1,174 | 4 | 176 | -81.8% |
| Maryland | $53 | $3,475 | 79 | 2,846 | -82.5% |
| Montana | $50 | $280 | 11 | 278 | -83.6% |
| Rhode Island | $50 | $1,203 | 5 | 45 | -83.6% |
| New Mexico | $49 | $1,761 | 6 | 70 | -83.8% |
| Hawaii | $49 | $975 | 7 | 171 | -83.9% |
| Wyoming | $48 | $1,115 | 5 | 122 | -84.2% |
| North Dakota | $48 | $605 | 4 | 117 | -84.2% |
| Vermont | $48 | $2,180 | 4 | 146 | -84.2% |
| West Virginia | $48 | $885 | 13 | 214 | -84.3% |
| Maine | $48 | $111 | 4 | 91 | -84.4% |
| Alabama | $47 | $432 | 30 | 559 | -84.5% |
| South Dakota | $47 | $1,035 | 9 | 157 | -84.6% |
| Idaho | $46 | $664 | 17 | 477 | -84.9% |
| Arkansas | $45 | $840 | 21 | 348 | -85.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
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