70160

X-ray of nose bones, minimum of 3 views

Medicare pricing data for 4,309 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $8 in Puerto Rico to $37 in New Jersey. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

X-ray of nose bones, minimum of 3 views (HCPCS code 70160) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $27.57, but hospitals typically charge $85.35 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $27.57, your out-of-pocket cost would be approximately $5.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$27.57
Average Hospital Charge
$85.35
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$85.35
Medicare Allowed$27.57
Medicare Payment$19.84

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $19.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$37$110170237+35.1%
California$36$109397693+31.3%
Arizona$34$1135670+22.2%
Rhode Island$33$873250+19.8%
New York$32$91367783+15.3%
Florida$30$93221324+10.3%
Virginia$30$85141199+8.7%
Colorado$29$915969+6.9%
Maryland$28$75190489+2.4%
Alabama$28$735966+1.8%
Texas$28$96264351+1.5%
Massachusetts$27$78111170-2.1%
Hawaii$27$771019-2.6%
Oregon$26$733948-5.1%
Pennsylvania$26$72243359-6.3%
Tennessee$26$62100155-6.7%
Utah$26$592736-6.8%
Wisconsin$26$1486183-6.8%
Louisiana$26$7479123-7.3%
Michigan$25$54103148-9.9%
West Virginia$25$662324-10.6%
Nebraska$24$703844-11.8%
North Dakota$24$871318-13.1%
Connecticut$24$674668-13.2%
Nevada$24$1842939-13.2%
New Mexico$24$751820-14.0%
South Carolina$24$8699117-14.3%
Iowa$24$706383-14.7%
Delaware$23$792448-15.2%
Kansas$23$584767-15.3%
Mississippi$23$674046-15.5%
Oklahoma$23$605590-15.9%
Washington$23$83100136-18.2%
Indiana$22$887183-19.3%
North Carolina$22$65157202-19.6%
Illinois$22$114199333-19.6%
Montana$22$691313-20.2%
Arkansas$22$505884-20.5%
Idaho$22$781618-20.8%
Georgia$22$7292105-21.5%
New Hampshire$22$972734-21.9%
Minnesota$21$886388-23.8%
Kentucky$21$566680-24.0%
Ohio$20$5984180-28.1%
Missouri$18$4978159-33.7%
South Dakota$16$371922-43.3%
Maine$8$371921-70.3%
Puerto Rico$8$15811-70.5%

⚠️ 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