76100

X-ray of body plane

Medicare pricing data for 104 providers across 18 states

🤖AI Overview

Prices vary significantly by location — from $27 in South Carolina to $101 in California. Where you get this procedure matters more than almost any other factor. 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

X-ray of body plane (HCPCS code 76100) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $94.01, but hospitals typically charge $168.13 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$18.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $94.01, your out-of-pocket cost would be approximately $18.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$94.01
Average Hospital Charge
$168.13
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$168.13
Medicare Allowed$94.01
Medicare Payment$72.93

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $72.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$101$142234,139+7.7%
Washington$91$27915568-3.3%
Nevada$90$1401100-4.1%
Minnesota$89$279435-5.0%
Virginia$89$130180-5.1%
Colorado$88$1992142-6.6%
Iowa$87$262584-7.2%
Texas$87$1998571-7.4%
Arizona$85$163121,622-9.1%
Utah$85$150184-9.9%
Ohio$85$1501128-10.0%
Michigan$84$25414348-11.0%
Illinois$83$115298-11.9%
Idaho$78$271143-17.4%
New York$28$97411-70.6%
North Carolina$27$12131452-71.5%
Tennessee$27$1321219-71.6%
South Carolina$27$121261-71.8%

⚠️ 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

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