57454

Biopsy and scraping of cervix using an endoscope

Medicare pricing data for 9,080 providers across 52 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

Biopsy and scraping of cervix using an endoscope (HCPCS code 57454) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $164.14, but hospitals typically charge $546.61 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$32.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $164.14, your out-of-pocket cost would be approximately $32.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$164.14
Average Hospital Charge
$546.61
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$546.61
Medicare Allowed$164.14
Medicare Payment$116.19

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $116.19 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$198$1,0533039+20.9%
District of Columbia$188$4433857+14.7%
New York$187$8539041,834+13.7%
New Jersey$179$684350636+9.0%
California$175$5198861,536+6.7%
Connecticut$175$567155207+6.5%
Maryland$173$457235373+5.1%
Florida$170$6305941,125+3.3%
Rhode Island$168$4742735+2.4%
Massachusetts$165$497336650+0.7%
Illinois$165$604377585+0.7%
Nevada$165$42765103+0.6%
Hawaii$164$3862836+0.1%
Virginia$163$410247368-0.4%
Colorado$162$477138190-1.4%
Washington$162$461151203-1.5%
Delaware$161$4614060-2.1%
Pennsylvania$160$496428678-2.2%
Utah$159$3593137-3.2%
Georgia$159$514203286-3.3%
Oregon$159$540117165-3.4%
Puerto Rico$157$2543251-4.1%
Michigan$156$356287416-4.8%
Arizona$156$375153262-5.1%
Alabama$156$356101146-5.2%
Texas$156$448493651-5.2%
South Carolina$155$461145222-5.5%
Wyoming$154$6111821-6.0%
Kentucky$152$3717699-7.4%
Ohio$152$463293431-7.4%
Mississippi$152$41164100-7.5%
Missouri$151$419154215-8.2%
Arkansas$150$3476391-8.4%
North Carolina$150$484313465-8.7%
Oklahoma$150$345100147-8.8%
Indiana$149$390157241-9.3%
Iowa$147$435101144-10.2%
Tennessee$147$406138192-10.3%
Minnesota$147$622197295-10.5%
Montana$147$4593555-10.7%
Kansas$146$44977105-10.9%
Louisiana$145$404125194-11.8%
New Hampshire$144$66361118-12.3%
Wisconsin$143$957143184-12.7%
New Mexico$143$3715983-13.0%
West Virginia$142$4124175-13.5%
South Dakota$141$3213647-14.0%
Nebraska$140$4225977-14.9%
Maine$138$3984862-15.6%
North Dakota$138$3232742-15.7%
Idaho$136$3604567-17.0%
Vermont$136$3292456-17.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber