75565

Mri scan of blood flow of heart

Medicare pricing data for 1,294 providers across 40 states

🤖AI Overview

This procedure has a 8.4x markup — hospitals charge $131.42 but Medicare allows only $15.59. Uninsured patients may face bills 8.4 times higher than what insurance negotiates. Prices vary significantly by location — from $11 in Arkansas to $55 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 blood flow of heart (HCPCS code 75565) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $15.59, but hospitals typically charge $131.42 — a 8.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.12

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $15.59, your out-of-pocket cost would be approximately $3.12. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$15.59
Average Hospital Charge
$131.42
Markup Ratio
8.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$131.42
Medicare Allowed$15.59
Medicare Payment$12.27

Hospitals charge 8.4x more than what Medicare allows for this procedure. Medicare actually pays $12.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$55$556276+249.7%
Utah$29$1,351635+87.6%
California$24$525104989+53.7%
North Carolina$23$254521,884+50.1%
New York$22$291771,218+41.7%
Maryland$18$10323105+17.1%
Alabama$17$13917102+8.3%
Missouri$17$9828307+8.3%
Pennsylvania$16$58971,385+0.3%
Texas$15$92762,164-0.8%
Washington$15$6136263-0.9%
Virginia$15$13036405-3.8%
Colorado$14$12529197-7.2%
New Jersey$14$10624182-7.6%
Massachusetts$14$7754382-8.0%
Connecticut$14$6321403-10.8%
Florida$14$9249560-12.8%
Minnesota$13$6956387-14.0%
District of Columbia$13$95427-17.9%
Wisconsin$13$16226233-19.1%
Tennessee$13$61451,160-19.6%
Illinois$12$73711,836-21.1%
Rhode Island$12$58316-22.4%
Oregon$12$3210238-23.1%
Michigan$12$6445532-23.7%
Ohio$12$681021,778-24.1%
Nevada$12$42216-24.2%
Arizona$12$6925269-24.2%
New Hampshire$12$558234-24.5%
Georgia$12$5455987-25.2%
North Dakota$12$37757-25.7%
South Dakota$11$60132-26.6%
Mississippi$11$67432-26.6%
Iowa$11$98620-26.8%
Louisiana$11$36259-27.0%
Indiana$11$6728510-27.1%
Oklahoma$11$669277-27.3%
South Carolina$11$43887-27.5%
Kentucky$11$4217263-28.2%
Arkansas$11$24414-29.8%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber