76519

Ultrasound scan to determine eye length and lens power

Medicare pricing data for 4,360 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $30 in Vermont to $77 in District of Columbia. 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

Ultrasound scan to determine eye length and lens power (HCPCS code 76519) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $49.20, but hospitals typically charge $167.27 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.84

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $49.20, your out-of-pocket cost would be approximately $9.84. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$49.20
Average Hospital Charge
$167.27
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$167.27
Medicare Allowed$49.20
Medicare Payment$36.03

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $36.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$77$24718268+56.7%
Alaska$66$35112250+34.5%
Colorado$64$158451,082+30.7%
Montana$62$8710352+26.2%
Puerto Rico$60$7363549+22.0%
Maryland$58$1771114,018+18.3%
New Jersey$58$1751937,723+17.2%
South Dakota$57$282863+15.5%
California$55$17448612,639+12.5%
New York$55$17439310,363+10.9%
Idaho$53$1291286+7.5%
Connecticut$53$200691,904+7.1%
Michigan$52$1471412,865+5.9%
Pennsylvania$51$1743068,180+4.1%
Indiana$51$161621,643+3.3%
Wisconsin$50$294822,149+2.6%
Utah$50$13113259+2.2%
Massachusetts$50$2161152,012+1.9%
Illinois$49$2301583,748+0.5%
Kansas$49$189393,184-0.2%
Florida$49$1722437,723-0.5%
Arizona$49$131852,016-0.8%
Texas$48$1582665,947-1.9%
Nevada$47$21324434-3.6%
Washington$47$137113906-3.6%
Missouri$47$149781,705-5.3%
Maine$46$14318616-5.8%
Louisiana$46$156631,761-5.9%
Nebraska$45$138291,742-7.6%
Arkansas$45$178312,214-8.8%
New Mexico$45$12724518-9.2%
Georgia$44$167761,001-9.8%
Minnesota$44$1501071,850-10.1%
Oklahoma$44$139472,286-10.3%
Virginia$44$119964,739-11.2%
Oregon$44$147682,127-11.3%
South Carolina$44$171491,863-11.5%
New Hampshire$43$149845-11.6%
Rhode Island$43$17715273-12.0%
Tennessee$43$128821,767-12.0%
Alabama$43$14650301-12.9%
Ohio$41$1611041,831-16.0%
North Dakota$41$14112198-17.0%
Delaware$40$96163,224-18.7%
Hawaii$39$16415488-21.1%
West Virginia$39$13419971-21.5%
Kentucky$38$124511,417-22.0%
Iowa$38$124481,193-23.2%
North Carolina$38$161952,955-23.3%
Mississippi$36$187524,259-25.9%
Wyoming$33$1991286-32.0%
Vermont$30$108313-39.8%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber