72197

Mri scan of pelvis before and after contrast

Medicare pricing data for 19,584 providers across 52 states

🤖AI Overview

This procedure has a 6.8x markup — hospitals charge $1,325 but Medicare allows only $195.55. Uninsured patients may face bills 6.8 times higher than what insurance negotiates. Prices vary significantly by location — from $101 in West Virginia to $284 in Alaska. 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 pelvis before and after contrast (HCPCS code 72197) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $195.55, but hospitals typically charge $1,325 — a 6.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$39.11

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $195.55, your out-of-pocket cost would be approximately $39.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$195.55
Average Hospital Charge
$1,325
Markup Ratio
6.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,325.02
Medicare Allowed$195.55
Medicare Payment$149.23

Hospitals charge 6.8x more than what Medicare allows for this procedure. Medicare actually pays $149.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$284$2,91056720+45.5%
New Jersey$272$1,7855158,820+39.3%
Maryland$267$1,3944148,369+36.7%
Nevada$249$1,5031512,188+27.2%
Florida$243$1,9271,37126,444+24.2%
New York$238$1,5241,30735,610+21.8%
California$234$1,5841,99238,863+19.9%
Rhode Island$226$1,459831,191+15.5%
Arizona$225$1,7913619,165+15.0%
District of Columbia$224$1,296591,148+14.3%
Wyoming$223$1,61244502+14.3%
Puerto Rico$212$29048291+8.6%
New Mexico$207$1,7981011,644+5.7%
Minnesota$206$1,8646658,229+5.2%
Massachusetts$199$1,29958013,348+1.7%
Hawaii$198$98052856+1.3%
Connecticut$193$1,1652634,004-1.2%
Vermont$193$1,26240650-1.4%
Virginia$192$1,56750310,645-1.6%
Washington$192$1,0635295,804-2.0%
Colorado$190$9853455,764-2.8%
Delaware$189$843511,647-3.6%
Texas$185$1,3361,36923,418-5.4%
Tennessee$182$1,1603765,110-7.1%
Idaho$176$1,3591031,402-10.0%
Oregon$175$1,0252613,332-10.4%
Pennsylvania$164$97087714,740-16.0%
Kansas$164$7441982,601-16.2%
Illinois$162$1,15788113,271-17.4%
North Carolina$157$1,1806309,460-19.9%
South Carolina$157$1,3342695,509-19.9%
Arkansas$153$7102093,009-21.8%
Louisiana$152$8532633,445-22.1%
Iowa$151$8471872,524-22.7%
Utah$151$9071361,360-22.9%
Montana$148$91870957-24.5%
Alabama$146$8253143,411-25.6%
Nebraska$144$8271372,197-26.1%
Missouri$140$7654096,874-28.4%
Kentucky$138$6761862,333-29.2%
Ohio$136$9185748,641-30.3%
Georgia$136$9785238,610-30.3%
Indiana$130$6843213,446-33.5%
Maine$128$658821,058-34.6%
Michigan$127$6085507,413-35.0%
New Hampshire$127$1,1821241,829-35.2%
Mississippi$122$8071411,731-37.6%
South Dakota$120$55059649-38.9%
Wisconsin$119$1,2874724,924-38.9%
North Dakota$112$46463786-42.7%
Oklahoma$108$5081632,138-44.8%
West Virginia$101$43588821-48.5%

⚠️ 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