74330

Review by radiologist of image from tube placement into bile and pancreatic duct using an endoscope

Medicare pricing data for 2,437 providers across 47 states

🤖AI Overview

This procedure has a 7.5x markup — hospitals charge $193.75 but Medicare allows only $25.75. Uninsured patients may face bills 7.5 times higher than what insurance negotiates. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 image from tube placement into bile and pancreatic duct using an endoscope (HCPCS code 74330) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $25.75, but hospitals typically charge $193.75 — a 7.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.15

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $25.75, your out-of-pocket cost would be approximately $5.15. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$25.75
Average Hospital Charge
$193.75
Markup Ratio
7.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$193.75
Medicare Allowed$25.75
Medicare Payment$20.28

Hospitals charge 7.5x more than what Medicare allows for this procedure. Medicare actually pays $20.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$37$244714+45.0%
New Jersey$29$26757212+14.5%
California$29$223248944+12.9%
Connecticut$29$18651165+12.2%
District of Columbia$29$152959+12.1%
New York$29$244112408+11.7%
Washington$28$14273301+9.3%
Maryland$28$1622553+8.9%
Hawaii$28$380618+8.6%
New Mexico$28$149714+8.4%
Maine$28$1461431+7.7%
Montana$28$1461832+7.1%
Michigan$27$17269233+6.4%
North Dakota$27$1751552+5.1%
Nevada$27$2962246+5.0%
Oregon$27$12255174+4.9%
Missouri$27$17560190+3.9%
Utah$27$1391318+3.5%
Arizona$27$18845183+3.5%
Texas$27$262135381+3.0%
Minnesota$26$1783571+2.2%
New Hampshire$26$1482033+2.1%
Rhode Island$26$2301732+1.7%
Kansas$26$14428144+1.0%
Idaho$26$1081221+1.0%
Wisconsin$26$27973140+0.5%
Iowa$26$1702796+0.4%
Louisiana$26$2063262-0.6%
Colorado$26$13943112-0.7%
Oklahoma$25$15429116-1.2%
Alabama$25$1132746-1.3%
Nebraska$25$13940191-1.3%
Ohio$25$21664218-1.6%
Indiana$25$20070219-1.7%
Massachusetts$25$16267421-1.8%
Pennsylvania$25$165108313-2.8%
West Virginia$25$1692250-4.4%
Illinois$24$212126467-5.2%
Mississippi$24$3791633-5.7%
Arkansas$23$165917-11.2%
North Carolina$22$17786227-15.9%
Georgia$22$16866158-16.4%
South Carolina$22$1704166-16.4%
Virginia$21$16081288-16.6%
Florida$21$225153410-19.8%
Kentucky$19$11749132-25.0%
Tennessee$19$17146145-26.9%

⚠️ 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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