58558

Biopsy of lining of uterus and/or removal of polyp using an endoscope

Medicare pricing data for 17,216 providers across 52 states

🤖AI Overview

This procedure has a 6.2x markup — hospitals charge $3,130 but Medicare allows only $503.88. Uninsured patients may face bills 6.2 times higher than what insurance negotiates. Prices vary significantly by location — from $214 in South Dakota to $834 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

Biopsy of lining of uterus and/or removal of polyp using an endoscope (HCPCS code 58558) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $503.88, but hospitals typically charge $3,130 — a 6.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$100.78

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $503.88, your out-of-pocket cost would be approximately $100.78. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$503.88
Average Hospital Charge
$3,130
Markup Ratio
6.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,129.57
Medicare Allowed$503.88
Medicare Payment$396.59

Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $396.59 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$834$8,21653162+65.5%
New York$688$4,2961,3384,235+36.5%
California$665$4,0291,3364,088+32.0%
Florida$662$3,6831,2034,260+31.3%
New Jersey$627$4,2606571,934+24.5%
Maryland$624$3,1293911,574+23.8%
Arizona$600$2,8313351,014+19.0%
Hawaii$588$2,71970142+16.6%
Wyoming$559$3,3022569+11.0%
Nevada$544$4,224125304+8.0%
Oregon$519$2,781213529+3.0%
Tennessee$515$2,0343411,049+2.2%
Massachusetts$510$3,0575571,866+1.2%
Texas$510$4,1989502,218+1.1%
Utah$490$1,95895194-2.7%
Virginia$488$2,6135281,521-3.2%
New Mexico$487$2,99596238-3.3%
Puerto Rico$485$6624274-3.7%
Montana$468$2,20359210-7.2%
Alabama$440$1,932192401-12.7%
Michigan$425$2,0146881,666-15.6%
Delaware$424$2,53968341-15.9%
Kansas$418$3,123151460-17.0%
Illinois$413$3,0518092,078-18.0%
Louisiana$411$2,761197415-18.5%
Colorado$410$2,433251583-18.6%
Connecticut$407$3,379256531-19.3%
Minnesota$406$3,494332892-19.5%
North Carolina$405$3,3065461,235-19.7%
Indiana$403$3,5514011,166-20.1%
New Hampshire$403$2,802119296-20.1%
Georgia$401$2,770430949-20.3%
Pennsylvania$394$2,0678762,768-21.8%
Iowa$385$2,213179550-23.7%
Nebraska$377$2,663114288-25.2%
Arkansas$377$1,759153395-25.2%
Kentucky$371$1,632235644-26.3%
Mississippi$363$2,261112301-27.9%
Missouri$363$2,481331930-28.0%
West Virginia$357$2,373105308-29.1%
North Dakota$354$2,6633796-29.7%
Washington$352$1,794279692-30.1%
Ohio$342$1,7527671,814-32.2%
Wisconsin$338$4,197328807-33.0%
Vermont$331$3,50336118-34.3%
South Carolina$330$2,658300796-34.5%
Oklahoma$282$1,296172421-44.0%
Idaho$276$1,45059119-45.1%
Maine$262$1,49562128-48.0%
District of Columbia$254$2,00866182-49.5%
Rhode Island$228$2,11362149-54.8%
South Dakota$214$1,08952122-57.4%

⚠️ 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