72128

Ct scan of middle spine without contrast

Medicare pricing data for 24,162 providers across 52 states

🤖AI Overview

This procedure has a 6.3x markup — hospitals charge $317.98 but Medicare allows only $50.42. Uninsured patients may face bills 6.3 times higher than what insurance negotiates. 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

Ct scan of middle spine without contrast (HCPCS code 72128) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $50.42, but hospitals typically charge $317.98 — a 6.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $50.42, your out-of-pocket cost would be approximately $10.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$50.42
Average Hospital Charge
$317.98
Markup Ratio
6.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$317.98
Medicare Allowed$50.42
Medicare Payment$38.76

Hospitals charge 6.3x more than what Medicare allows for this procedure. Medicare actually pays $38.76 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$72$57778454+42.7%
Maryland$61$2975174,125+20.3%
New Jersey$59$4025844,082+17.1%
District of Columbia$58$26181821+14.0%
New York$57$3241,25513,002+12.5%
California$57$3642,24919,314+12.5%
Florida$54$3641,73618,184+7.1%
Nevada$53$4152251,748+5.1%
Wyoming$53$39343323+5.1%
Arizona$52$3924215,415+2.8%
Connecticut$52$3073562,604+2.5%
Colorado$52$3264224,155+2.3%
Puerto Rico$51$21233177+2.0%
Montana$51$28684389+1.8%
Delaware$51$26468564+1.2%
Louisiana$51$3113401,908+0.5%
Texas$50$4081,71520,955-0.0%
Washington$50$2295184,960-0.7%
Massachusetts$50$2436244,512-0.8%
Rhode Island$50$2341041,507-1.5%
South Carolina$50$3223762,169-1.8%
Minnesota$49$31592810,951-1.9%
Georgia$49$3306655,221-2.0%
Virginia$49$3006455,949-2.0%
Tennessee$49$3406734,791-2.6%
New Mexico$48$276131840-3.8%
North Carolina$48$3338747,142-4.0%
Hawaii$48$22192717-4.8%
Illinois$48$3239819,046-5.0%
Oregon$48$2342822,037-5.6%
Oklahoma$47$2782753,079-5.9%
Pennsylvania$47$2431,0559,739-5.9%
Maine$47$23786350-6.1%
Kansas$47$2082292,668-6.2%
North Dakota$47$21175527-6.6%
Missouri$47$2505627,304-6.7%
Alabama$47$2484013,876-7.4%
New Hampshire$47$6021251,155-7.5%
Michigan$46$2216908,622-8.2%
Iowa$46$2772001,310-8.5%
Idaho$46$328115845-8.8%
Mississippi$46$2951921,837-9.2%
Indiana$46$2904013,750-9.3%
Nebraska$46$2151881,933-9.4%
Kentucky$46$2442953,344-9.5%
Arkansas$46$2062512,481-9.8%
South Dakota$45$19673639-9.8%
Wisconsin$45$4765423,514-9.9%
Ohio$45$30889511,061-10.3%
Utah$45$1712142,483-10.3%
West Virginia$45$2451401,529-11.3%
Vermont$44$27431363-12.1%

⚠️ 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