76604

Ultrasound scan of chest

Medicare pricing data for 26,569 providers across 52 states

🤖AI Overview

This procedure has a 5.6x markup — hospitals charge $169.01 but Medicare allows only $30.38. Uninsured patients may face bills 5.6 times higher than what insurance negotiates. 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 of chest (HCPCS code 76604) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $30.38, but hospitals typically charge $169.01 — a 5.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $30.38, your out-of-pocket cost would be approximately $6.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$30.38
Average Hospital Charge
$169.01
Markup Ratio
5.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$169.01
Medicare Allowed$30.38
Medicare Payment$23.46

Hospitals charge 5.6x more than what Medicare allows for this procedure. Medicare actually pays $23.46 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$39$30780287+28.3%
Puerto Rico$35$822593+16.0%
Hawaii$35$16288351+15.6%
New York$35$2251,83111,056+13.9%
Maryland$34$1394762,316+10.3%
New Jersey$34$1907142,627+10.3%
Washington$33$1375831,964+7.8%
Connecticut$32$1824602,131+6.9%
California$32$1743,01418,231+6.2%
Alabama$32$1323291,408+4.5%
Wyoming$31$15644111+3.6%
New Mexico$31$198121313+3.1%
Virginia$31$1316982,288+2.3%
Kansas$31$116235779+1.5%
Arizona$31$2205022,752+1.4%
Iowa$31$155243741+1.4%
Utah$31$119156353+1.1%
Florida$31$1851,75210,187+0.7%
Texas$31$2131,6899,449+0.5%
Tennessee$30$1575021,564+0.1%
District of Columbia$30$16786369+0.1%
Rhode Island$30$146176623+0.1%
Illinois$30$1709593,340-1.3%
Colorado$30$1624851,212-1.4%
Oregon$30$125323839-2.4%
Nevada$30$1912452,480-2.8%
New Hampshire$29$222167521-3.3%
Louisiana$29$1622931,105-6.1%
Massachusetts$28$1381,0805,716-6.5%
Michigan$28$1189183,268-7.0%
North Dakota$28$14284236-7.2%
Pennsylvania$28$1231,4315,652-7.7%
Indiana$28$1434051,562-8.0%
North Carolina$28$1557772,118-8.1%
Wisconsin$28$2495111,273-8.1%
Georgia$28$1445872,011-8.2%
Idaho$28$147146439-8.7%
Arkansas$28$1102071,441-9.0%
Missouri$28$1435442,130-9.3%
Maine$27$105153422-9.6%
Vermont$27$15383298-9.8%
Minnesota$27$1757683,348-9.9%
South Dakota$27$10274236-10.0%
Montana$27$14474313-10.5%
South Carolina$27$1154592,259-10.5%
Oklahoma$27$1342301,006-12.0%
Kentucky$27$105286918-12.0%
Nebraska$27$111213987-12.5%
Ohio$26$1597853,049-13.2%
Delaware$26$116101488-13.5%
West Virginia$26$116157759-14.3%
Mississippi$26$151195856-14.5%

⚠️ 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