69801

Incision of fluid canal of inner ear with infusion of drugs

Medicare pricing data for 3,268 providers across 49 states

🤖AI Overview

This procedure has a 6.6x markup — hospitals charge $1,433 but Medicare allows only $216.44. Uninsured patients may face bills 6.6 times higher than what insurance negotiates. Prices vary significantly by location — from $117 in North Dakota to $281 in District of Columbia. 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

Incision of fluid canal of inner ear with infusion of drugs (HCPCS code 69801) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $216.44, but hospitals typically charge $1,433 — a 6.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$43.29

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $216.44, your out-of-pocket cost would be approximately $43.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$216.44
Average Hospital Charge
$1,433
Markup Ratio
6.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,433.24
Medicare Allowed$216.44
Medicare Payment$168.89

Hospitals charge 6.6x more than what Medicare allows for this procedure. Medicare actually pays $168.89 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$281$4,096477+29.7%
Alaska$272$2,6631245+25.5%
New Jersey$264$2,12192785+22.2%
New York$259$2,833142926+19.9%
Connecticut$250$1,5071999+15.5%
Maryland$245$1,09691609+13.1%
California$245$1,5242912,021+13.0%
Indiana$236$1,46062693+8.9%
Hawaii$235$1,273651+8.6%
Delaware$233$5971091+7.9%
Nevada$230$1,25215123+6.4%
Virginia$228$96591507+5.3%
Minnesota$227$86841134+4.8%
Oregon$226$76544205+4.3%
Colorado$225$82776401+3.7%
Florida$222$9942482,376+2.8%
Texas$218$1,3092392,194+0.7%
Pennsylvania$218$1,5021531,046+0.6%
Washington$217$85688502+0.3%
Georgia$216$1,61795366-0.1%
Illinois$214$1,51599524-1.2%
Oklahoma$212$74123115-2.0%
Kentucky$212$1,09949318-2.3%
North Carolina$211$1,587121743-2.3%
Arizona$211$57355633-2.4%
Michigan$209$847102592-3.3%
Missouri$209$1,03068568-3.4%
Mississippi$208$1,09221239-4.0%
Utah$207$93135142-4.2%
Iowa$205$1,08937193-5.4%
Louisiana$204$1,99961203-5.7%
Arkansas$203$5031381-6.1%
Idaho$203$8151894-6.2%
West Virginia$203$1,5221248-6.4%
South Carolina$201$1,51878558-7.0%
Alabama$201$2,376681,398-7.2%
Maine$201$6521052-7.2%
Nebraska$201$1,01724110-7.3%
Massachusetts$200$1,964100560-7.8%
Kansas$199$1,20534220-7.9%
Montana$199$552861-8.2%
South Dakota$193$829828-10.6%
Wisconsin$190$3,05749178-12.3%
Ohio$184$1,434127663-15.1%
Tennessee$170$1,417951,576-21.7%
New Hampshire$169$7701677-22.0%
New Mexico$156$9231760-28.0%
Vermont$121$381626-44.0%
North Dakota$117$302726-45.8%

⚠️ 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