73580

Review by radiologist of knee joint image

Medicare pricing data for 582 providers across 37 states

🤖AI Overview

Prices vary significantly by location — from $35 in Indiana to $171 in New York. 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

Review by radiologist of knee joint image (HCPCS code 73580) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $123.39, but hospitals typically charge $351.92 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.68

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $123.39, your out-of-pocket cost would be approximately $24.68. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$123.39
Average Hospital Charge
$351.92
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$351.92
Medicare Allowed$123.39
Medicare Payment$97.05

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $97.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$171$37731657+38.7%
Connecticut$155$1762224+25.4%
Ohio$152$4457155+22.8%
Minnesota$144$259519+16.6%
New Jersey$140$27516363+13.7%
California$137$499491,913+11.3%
Pennsylvania$136$30910239+10.3%
Nevada$129$407820+4.9%
Kentucky$129$2997107+4.7%
Illinois$129$379252,865+4.5%
Virginia$125$405632+1.5%
Washington$124$4258573+0.6%
Maryland$121$226690-2.1%
Florida$121$331852,300-2.2%
Utah$120$2201106-2.6%
Georgia$120$34537805-2.9%
Louisiana$117$307333-5.2%
South Carolina$116$3867145-5.7%
Texas$114$291631,218-7.2%
Tennessee$114$3381053-7.5%
Maine$114$319197-7.6%
North Carolina$114$3119258-7.8%
Colorado$113$21512133-8.1%
New Hampshire$112$319150-9.3%
Arizona$111$54511130-10.2%
Missouri$110$32824615-10.9%
Massachusetts$108$29610144-12.1%
Alabama$108$3435152-12.1%
New Mexico$103$268327-16.8%
Kansas$102$3486104-17.4%
Iowa$100$2233118-18.7%
Nebraska$100$2147288-18.8%
Idaho$98$257443-20.3%
Oklahoma$97$2383207-21.2%
Mississippi$93$213521-24.9%
Michigan$88$27815422-28.9%
Indiana$35$1195137-71.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber