72074

X-ray of middle spine, minimum of 4 views

Medicare pricing data for 2,725 providers across 48 states

🤖AI Overview

Prices vary significantly by location — from $11 in Idaho to $48 in Alaska. 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 middle spine, minimum of 4 views (HCPCS code 72074) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $35.00, but hospitals typically charge $126.90 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.00

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $35.00, your out-of-pocket cost would be approximately $7.00. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$35.00
Average Hospital Charge
$126.90
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$126.90
Medicare Allowed$35.00
Medicare Payment$25.62

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $25.62 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$48$3131232+36.1%
New Jersey$47$149132288+32.9%
California$44$164287558+26.7%
Puerto Rico$41$561419+17.0%
New York$40$137155359+12.9%
Arizona$39$106137942+12.3%
Colorado$39$13250102+10.3%
District of Columbia$38$155911+7.4%
Texas$38$172262612+7.2%
Utah$37$1621415+5.9%
Michigan$37$8546109+5.5%
Louisiana$37$1472867+5.4%
New Mexico$36$1461327+3.3%
Florida$36$128263596+3.0%
Nevada$35$1823539+0.6%
Mississippi$35$1202053+0.3%
Minnesota$34$1522335-3.1%
Delaware$34$1021224-3.8%
Oklahoma$33$983568-5.0%
Indiana$33$1372638-5.1%
Maryland$32$92101366-7.2%
Virginia$32$10490157-7.3%
Alabama$32$9844170-8.7%
Washington$30$1074576-14.0%
Iowa$30$140814-14.5%
Georgia$29$13480124-16.0%
Hawaii$29$101913-17.3%
Missouri$28$953139-20.1%
North Carolina$28$120179394-20.3%
Tennessee$27$8971125-22.0%
Wisconsin$27$2462941-23.2%
Connecticut$27$1531421-23.5%
Massachusetts$26$982234-25.6%
Illinois$26$18172169-26.2%
South Carolina$25$944970-28.3%
Pennsylvania$25$9396144-28.7%
Kansas$24$782643-30.7%
Arkansas$24$901315-31.7%
Kentucky$23$811638-35.2%
Oregon$19$651327-45.9%
Ohio$18$8767159-49.7%
West Virginia$17$562246-52.1%
New Hampshire$16$731214-54.2%
Vermont$12$54713-65.5%
Wyoming$12$56614-66.7%
Maine$12$43713-66.9%
Nebraska$11$472857-67.7%
Idaho$11$891830-67.7%

⚠️ 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