57156

Insertion of device into vagina for radiation therapy

Medicare pricing data for 1,385 providers across 47 states

🤖AI Overview

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 device into vagina for radiation therapy (HCPCS code 57156) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $170.10, but hospitals typically charge $647.53 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$34.02

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $170.10, your out-of-pocket cost would be approximately $34.02. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$170.10
Average Hospital Charge
$647.53
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$647.53
Medicare Allowed$170.10
Medicare Payment$134.66

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $134.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$225$486435+32.5%
Arizona$224$41124385+31.4%
Arkansas$203$693986+19.4%
California$196$7561061,307+15.4%
Minnesota$195$8798129+14.7%
Louisiana$192$54922189+13.1%
Nevada$190$678892+12.0%
Texas$188$63486865+10.8%
Florida$187$5681201,174+10.2%
Maryland$187$47427292+9.9%
Oregon$183$66921224+7.6%
New York$180$1,09864733+5.8%
Washington$176$59938267+3.8%
Alabama$172$6171371+1.1%
Maine$172$413443+1.0%
Colorado$171$56025210+0.5%
New Mexico$168$541438-1.4%
South Carolina$167$52822194-2.0%
New Jersey$166$69736686-2.6%
Illinois$165$91860766-3.0%
Connecticut$164$63724287-3.3%
District of Columbia$164$441694-3.4%
Virginia$164$45737502-3.6%
Massachusetts$161$61033526-5.6%
Georgia$158$56657412-7.0%
Michigan$156$59355502-8.2%
Ohio$156$60863593-8.4%
Tennessee$154$46036476-9.4%
Delaware$154$4504139-9.5%
Pennsylvania$154$47587991-9.7%
New Hampshire$153$1,0047124-10.2%
Montana$153$348582-10.3%
Missouri$151$57730317-10.9%
Indiana$151$55137492-11.1%
North Dakota$149$609643-12.4%
Utah$147$431948-13.8%
South Dakota$146$310684-14.1%
North Carolina$144$63931464-15.1%
Kentucky$144$43216138-15.1%
Oklahoma$144$1,0136103-15.5%
Kansas$144$42612177-15.5%
Idaho$143$358430-15.9%
Wisconsin$142$1,27428293-16.3%
West Virginia$141$375572-16.9%
Mississippi$141$5551041-17.3%
Iowa$138$66813141-18.8%
Nebraska$137$483984-19.2%

⚠️ 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