76098

X-ray of surgical specimen

Medicare pricing data for 8,760 providers across 52 states

🤖AI Overview

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

X-ray of surgical specimen (HCPCS code 76098) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $16.35, but hospitals typically charge $58.25 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $16.35, your out-of-pocket cost would be approximately $3.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$16.35
Average Hospital Charge
$58.25
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$58.25
Medicare Allowed$16.35
Medicare Payment$12.88

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $12.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$20$12222198+21.4%
New Mexico$19$6157302+17.7%
Colorado$19$58129911+16.6%
New Jersey$19$672242,071+16.0%
North Carolina$19$663502,400+15.0%
Montana$19$4332190+14.3%
California$18$918357,916+12.2%
Washington$18$582041,661+12.0%
Maryland$18$471461,333+9.9%
New York$18$624784,895+9.5%
Minnesota$18$592371,118+8.1%
District of Columbia$17$5034309+2.6%
Massachusetts$17$563293,677+1.2%
North Dakota$16$4436265+0.9%
Virginia$16$501902,083-0.2%
Connecticut$16$50141852-0.2%
Florida$16$575535,135-0.9%
Oregon$16$35111929-2.3%
Illinois$16$604383,396-2.5%
Rhode Island$16$5232364-3.1%
Pennsylvania$15$503983,264-5.3%
Delaware$15$4522242-6.0%
Kansas$15$4072415-6.3%
Arizona$15$501221,439-6.5%
Iowa$15$48105806-7.0%
Michigan$15$402851,668-7.3%
New Hampshire$15$6053323-7.4%
Texas$15$504883,920-7.6%
Hawaii$15$4337218-7.8%
South Carolina$15$751401,727-7.8%
Missouri$15$491981,692-8.4%
Georgia$15$552621,835-8.5%
Nebraska$15$6594710-8.8%
Maine$15$2973569-9.1%
Ohio$15$533913,048-9.1%
Louisiana$15$39141859-9.1%
Wyoming$15$361861-9.1%
Tennessee$15$611801,385-9.2%
Vermont$15$6420104-9.3%
Wisconsin$15$772471,144-9.5%
South Dakota$15$3028273-10.0%
Alabama$15$3791549-10.0%
Utah$15$3053361-10.3%
West Virginia$15$4847252-10.3%
Oklahoma$15$3757653-11.3%
Kentucky$14$3998910-11.4%
Indiana$14$421791,565-11.7%
Mississippi$14$4767500-12.3%
Arkansas$14$5160536-12.3%
Idaho$14$3639327-12.4%
Puerto Rico$14$22927-13.1%
Nevada$14$4976510-14.4%

⚠️ 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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