72020

X-ray of spine, 1 view

Medicare pricing data for 13,298 providers across 51 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $78.33 but Medicare allows only $12.84. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $7 in West Virginia to $19 in California. 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

X-ray of spine, 1 view (HCPCS code 72020) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.84, but hospitals typically charge $78.33 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.84, your out-of-pocket cost would be approximately $2.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.84
Average Hospital Charge
$78.33
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$78.33
Medicare Allowed$12.84
Medicare Payment$9.75

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $9.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$19$2001,08219,615+48.8%
Texas$17$6294910,345+31.2%
Florida$16$727646,893+27.8%
Delaware$16$8746278+20.8%
New Jersey$15$783001,779+19.5%
South Dakota$15$4444135+15.0%
Wyoming$13$442458+2.5%
Iowa$13$491791,665-1.9%
Connecticut$12$552031,084-4.3%
Nevada$12$5994508-8.3%
New Hampshire$11$75101666-11.5%
Tennessee$11$453262,557-11.5%
Indiana$11$552701,686-11.7%
New York$11$445542,975-14.1%
Maryland$11$332924,347-14.5%
Alaska$11$6448285-15.3%
Mississippi$11$45125803-16.0%
Alabama$11$43142654-16.1%
Virginia$10$433471,591-18.5%
District of Columbia$10$3739225-20.6%
South Carolina$10$50170685-20.8%
Massachusetts$10$383433,407-20.9%
Wisconsin$10$603642,024-21.2%
Arizona$10$77213980-21.6%
Kentucky$9$35156608-26.2%
Pennsylvania$9$346594,837-26.3%
Oklahoma$9$38132887-26.6%
Utah$9$2597369-27.1%
Washington$9$443932,439-27.4%
Georgia$9$664031,806-28.4%
Illinois$9$625672,777-28.6%
Minnesota$9$444862,413-28.6%
North Carolina$9$465852,419-29.8%
Michigan$9$403521,902-30.1%
New Mexico$9$3552181-31.0%
Colorado$9$402771,408-31.0%
Arkansas$9$231841,468-31.8%
Oregon$9$34157531-32.6%
Missouri$9$433492,443-33.3%
Ohio$8$395633,591-34.7%
Nebraska$8$371491,678-36.8%
Hawaii$8$4244245-37.2%
Louisiana$8$38164654-37.3%
North Dakota$8$4343172-37.9%
Kansas$8$261451,813-38.4%
Rhode Island$8$3045316-38.9%
Idaho$8$5761539-39.6%
Montana$8$2435170-40.0%
Maine$8$2784339-40.7%
Vermont$8$4025148-41.1%
West Virginia$7$3051119-41.7%

⚠️ 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