58100

Biopsy of lining of uterus

Medicare pricing data for 21,448 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 of lining of uterus (HCPCS code 58100) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $92.68, but hospitals typically charge $333.04 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.54

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $92.68, your out-of-pocket cost would be approximately $18.54. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$92.68
Average Hospital Charge
$333.04
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$333.04
Medicare Allowed$92.68
Medicare Payment$69.17

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $69.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$112$73568172+21.0%
New Jersey$107$4037122,098+15.6%
District of Columbia$107$307103259+15.1%
California$104$3431,7805,486+12.7%
New York$103$4861,4914,402+11.4%
Maryland$103$3214461,350+10.8%
Nevada$99$247157404+7.1%
Connecticut$99$392356805+6.5%
Hawaii$98$27379156+6.0%
Florida$96$3911,1943,654+3.4%
Colorado$96$271403935+3.3%
Puerto Rico$94$3331320+1.4%
Pennsylvania$93$3301,1103,092+0.6%
Oregon$93$329303710+0.5%
Illinois$93$3779332,483+0.4%
Washington$93$2844851,132+0.2%
Wyoming$93$36250142-0.1%
Delaware$92$26487304-0.4%
Massachusetts$92$3506962,382-0.8%
Virginia$92$2866211,694-0.8%
Rhode Island$92$29896233-0.8%
Arizona$92$2563491,038-1.2%
Georgia$91$3245371,280-1.7%
Texas$90$3001,2852,952-2.4%
Utah$90$242191397-2.5%
South Carolina$89$302367994-3.6%
Alabama$89$228256500-4.2%
North Carolina$88$3118272,084-4.6%
Missouri$88$284408987-5.4%
Oklahoma$87$230244597-6.4%
Indiana$87$2744481,138-6.5%
Mississippi$86$276166434-7.4%
Tennessee$86$2654341,198-7.4%
Michigan$86$2357071,482-7.7%
Arkansas$85$229177492-7.8%
Kansas$84$240206542-9.5%
New Mexico$84$276134326-9.7%
Minnesota$84$365424871-9.8%
Kentucky$83$244264606-10.2%
Montana$83$221102293-10.2%
Ohio$83$2928281,890-10.4%
Louisiana$82$259261588-11.2%
Nebraska$81$269205590-12.4%
Iowa$79$290230738-14.5%
New Hampshire$79$281159456-14.7%
Wisconsin$79$5694811,226-14.9%
West Virginia$75$259112260-18.6%
Idaho$72$223135269-22.0%
South Dakota$71$17585264-23.7%
North Dakota$70$25683230-24.0%
Maine$70$21385211-24.8%
Vermont$67$18153159-28.2%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber