72156

Mri scan of upper spinal canal before and after contrast

Medicare pricing data for 18,459 providers across 52 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $1,082 but Medicare allows only $149.55. Uninsured patients may face bills 7.2 times higher than what insurance negotiates. Prices vary significantly by location — from $114 in Vermont to $263 in Puerto Rico. 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

Mri scan of upper spinal canal before and after contrast (HCPCS code 72156) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $149.55, but hospitals typically charge $1,082 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.91

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $149.55, your out-of-pocket cost would be approximately $29.91. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$149.55
Average Hospital Charge
$1,082
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,081.91
Medicare Allowed$149.55
Medicare Payment$116.45

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $116.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$263$4632751+75.9%
New Jersey$203$1,3944372,665+35.8%
Maryland$192$1,1513702,938+28.3%
Alaska$191$2,05566398+27.7%
District of Columbia$182$1,05452528+21.7%
Florida$181$1,4811,2437,792+21.0%
Nevada$178$1,302158786+19.1%
California$174$1,2511,68310,505+16.4%
New York$169$1,3141,0269,349+13.2%
Arizona$165$1,3243392,627+10.1%
Wyoming$164$1,35348183+9.4%
Hawaii$162$83850180+8.6%
Minnesota$161$1,4856274,136+7.8%
Massachusetts$154$1,0665224,533+2.9%
Connecticut$149$9872641,587-0.1%
Texas$149$1,1811,2119,246-0.6%
Virginia$148$1,4344823,620-0.8%
Alabama$146$8193411,473-2.2%
Colorado$144$8783332,159-3.5%
Delaware$144$84266496-3.6%
Rhode Island$144$80256585-4.0%
South Carolina$143$1,1223512,301-4.6%
Tennessee$143$1,0474952,747-4.7%
Washington$142$8054082,494-5.1%
Louisiana$142$9953071,439-5.2%
Georgia$141$1,0195192,772-5.4%
New Mexico$138$98290411-7.5%
North Carolina$135$1,0186774,103-9.9%
Indiana$134$9343511,875-10.4%
Illinois$133$1,0127825,292-11.2%
Oregon$133$7352221,432-11.3%
Kansas$130$6632051,160-13.1%
Pennsylvania$129$7738435,090-13.6%
Montana$128$74372457-14.2%
Maine$128$68268277-14.3%
Iowa$125$7721961,081-16.2%
New Hampshire$125$1,196127628-16.5%
Arkansas$124$6082031,069-17.1%
Michigan$124$6614854,504-17.2%
Kentucky$124$6432131,090-17.4%
Idaho$123$71283481-17.8%
Mississippi$122$1,0301851,134-18.1%
Wisconsin$122$1,3834652,201-18.1%
Utah$122$685160881-18.2%
Ohio$122$8135373,755-18.3%
Oklahoma$121$723218936-18.9%
Nebraska$120$6451251,018-19.5%
South Dakota$120$56959433-19.9%
North Dakota$119$61471409-20.1%
West Virginia$118$710110561-21.4%
Missouri$116$6503813,138-22.7%
Vermont$114$58430255-23.8%

⚠️ 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