72157

Mri scan of middle spinal canal before and after contrast

Medicare pricing data for 17,733 providers across 52 states

🤖AI Overview

This procedure has a 6.8x markup — hospitals charge $1,026 but Medicare allows only $150.03. Uninsured patients may face bills 6.8 times higher than what insurance negotiates. Prices vary significantly by location — from $113 in West Virginia to $272 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 middle spinal canal before and after contrast (HCPCS code 72157) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $150.03, but hospitals typically charge $1,026 — a 6.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$30.01

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $150.03, your out-of-pocket cost would be approximately $30.01. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$150.03
Average Hospital Charge
$1,026
Markup Ratio
6.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,026.38
Medicare Allowed$150.03
Medicare Payment$117.33

Hospitals charge 6.8x more than what Medicare allows for this procedure. Medicare actually pays $117.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$272$4611529+81.4%
Maryland$198$1,0723802,643+32.2%
New Jersey$196$1,3114332,434+30.4%
Alaska$194$1,83865319+29.0%
Nevada$186$1,256160722+24.0%
Florida$177$1,3701,1956,873+18.2%
District of Columbia$177$91555427+18.1%
California$174$1,1771,67010,234+15.9%
New York$173$1,3049858,779+15.1%
Minnesota$173$1,5106033,759+15.0%
Hawaii$167$75450164+11.1%
Arizona$166$1,2353172,217+10.7%
Wyoming$163$1,38342138+8.7%
Massachusetts$158$1,0115124,102+5.3%
Virginia$151$1,3814523,075+0.8%
Connecticut$148$9052551,447-1.5%
Washington$147$7634052,335-2.3%
Alabama$145$7463291,268-3.1%
Texas$145$1,1191,1928,176-3.1%
Rhode Island$144$76754548-3.7%
Colorado$144$8303362,005-4.0%
New Mexico$142$1,01785342-5.1%
Tennessee$139$9554492,224-7.4%
Delaware$139$73961409-7.5%
Montana$138$82268382-8.1%
South Carolina$138$1,0253091,641-8.2%
Pennsylvania$134$7378214,618-10.4%
Louisiana$134$8102881,079-10.6%
Oregon$133$6792171,264-11.5%
Georgia$132$8874972,436-12.1%
Kansas$131$657194955-12.4%
Illinois$130$9287454,523-13.0%
North Carolina$130$8886253,540-13.3%
Indiana$128$8333291,513-14.7%
Kentucky$128$657197884-14.8%
Maine$128$62866231-15.0%
New Hampshire$126$1,225130619-15.9%
Arkansas$124$578192975-17.6%
Idaho$123$69582438-17.7%
Ohio$123$7825393,328-18.1%
Utah$122$682156790-18.6%
Vermont$122$57330177-18.7%
Iowa$121$738178879-19.3%
Michigan$120$6104683,592-19.8%
Wisconsin$120$1,3004231,924-19.9%
Nebraska$120$618119753-20.0%
Oklahoma$118$625196921-21.5%
Missouri$117$6523732,625-21.8%
Mississippi$117$911162862-21.9%
North Dakota$116$50551337-23.0%
South Dakota$115$49049365-23.5%
West Virginia$113$644109465-24.7%

⚠️ 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