72052

X-ray of upper spine, 6 or more views

Medicare pricing data for 16,162 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $16 in West Virginia to $52 in New Jersey. 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 upper spine, 6 or more views (HCPCS code 72052) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $37.01, but hospitals typically charge $151.90 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.40

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $37.01, your out-of-pocket cost would be approximately $7.40. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$37.01
Average Hospital Charge
$151.90
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$151.90
Medicare Allowed$37.01
Medicare Payment$27.16

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $27.16 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$52$1916012,290+41.4%
Arizona$52$1923452,547+40.0%
Alaska$50$30746122+36.4%
Florida$49$1921,1596,199+32.1%
Maryland$48$1393101,389+29.7%
California$48$1901,4795,744+28.8%
Rhode Island$47$17056146+26.9%
Hawaii$47$17475231+26.0%
District of Columbia$46$20738142+24.0%
Nevada$41$160136318+11.8%
New York$41$1598653,602+9.9%
Virginia$38$1535992,986+2.5%
Wyoming$37$1453397+0.8%
Texas$37$1819633,914+0.6%
Delaware$37$12470270-0.5%
Colorado$37$131238738-0.7%
Connecticut$36$121190477-2.3%
Kansas$36$116138540-2.4%
New Hampshire$36$15485326-2.8%
Washington$35$164366993-6.6%
Utah$35$11289255-6.7%
Oklahoma$34$112191666-7.7%
Louisiana$34$1453121,247-9.1%
Arkansas$33$98106418-10.9%
Oregon$33$127179386-12.1%
Tennessee$32$1173951,233-13.6%
Alabama$32$1112871,087-13.8%
North Carolina$31$1296482,332-16.1%
Nebraska$31$122112309-16.3%
Indiana$31$137275718-16.9%
Kentucky$31$104247790-16.9%
Mississippi$30$12496350-18.0%
Georgia$30$1385201,971-20.0%
Missouri$30$1294001,435-20.0%
Illinois$30$1687172,641-20.0%
Massachusetts$28$1113581,164-23.2%
Michigan$28$1165382,148-23.5%
Puerto Rico$28$462980-23.9%
Idaho$27$158102244-26.5%
New Mexico$27$116108445-27.8%
Pennsylvania$26$1017652,247-29.9%
Iowa$26$128121372-30.1%
South Dakota$25$932026-32.3%
Montana$24$7972154-34.7%
Minnesota$24$110247573-36.2%
South Carolina$23$116243672-37.0%
Wisconsin$23$169267600-38.7%
Ohio$21$1156142,180-43.0%
Maine$20$9273126-46.0%
Vermont$17$942360-53.9%
North Dakota$16$931929-55.8%
West Virginia$16$80183835-56.7%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber