76942

Ultrasonic guidance for needle placement

Medicare pricing data for 60,740 providers across 52 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $320.31 but Medicare allows only $44.36. Uninsured patients may face bills 7.2 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

Ultrasonic guidance for needle placement (HCPCS code 76942) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $44.36, but hospitals typically charge $320.31 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $44.36, your out-of-pocket cost would be approximately $8.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$44.36
Average Hospital Charge
$320.31
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$320.31
Medicare Allowed$44.36
Medicare Payment$34.59

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $34.59 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$64$9031562,484+43.4%
New Jersey$53$4881,64020,663+19.5%
California$52$3805,70983,902+17.2%
New York$51$4373,70650,595+15.6%
Maryland$51$3071,18916,188+14.2%
Florida$50$2884,06068,136+12.0%
Puerto Rico$48$12087376+8.6%
Arizona$46$3011,61524,537+3.7%
Nevada$46$3645175,589+2.6%
New Mexico$45$2643723,598+0.7%
Virginia$45$2841,51117,697+0.5%
District of Columbia$44$2582261,665-0.5%
Colorado$44$2601,18610,196-0.9%
Illinois$44$3382,40227,162-1.5%
Washington$44$2501,42111,998-1.5%
Connecticut$44$3797588,657-1.8%
Maine$44$1843092,480-1.9%
Oregon$43$2427916,224-2.7%
Hawaii$43$1641491,278-3.4%
Michigan$43$2861,90819,013-3.6%
Delaware$42$2151751,980-4.3%
Texas$42$4014,51347,435-5.9%
Utah$42$2146645,561-6.0%
Rhode Island$42$2552031,827-6.4%
Wyoming$41$3461151,392-7.5%
North Carolina$41$3102,04718,801-8.1%
Pennsylvania$40$2252,53823,976-8.9%
New Hampshire$40$3793553,112-9.8%
Arkansas$40$1945296,781-10.3%
Georgia$40$2771,58712,682-10.3%
South Carolina$40$30295912,151-10.4%
South Dakota$40$2192163,384-10.7%
Tennessee$39$2721,32113,000-11.4%
Kentucky$39$27083810,057-11.8%
Alabama$39$2267267,168-11.9%
Massachusetts$39$2801,63513,782-12.0%
Minnesota$39$3361,23611,424-12.7%
Missouri$39$2821,17512,345-13.1%
Indiana$38$2871,35713,063-14.0%
Louisiana$38$2527527,362-14.3%
Oklahoma$37$1938109,702-15.5%
Mississippi$37$2434475,224-16.3%
Ohio$37$2342,66026,879-16.8%
Nebraska$36$1754885,494-18.3%
Wisconsin$36$5291,27911,210-18.3%
Kansas$36$2386046,552-18.8%
Iowa$36$2356286,006-19.9%
Montana$35$1712422,751-22.0%
Idaho$35$1983934,510-22.1%
West Virginia$34$2642411,979-23.4%
North Dakota$32$1411502,083-27.8%
Vermont$32$163112712-28.0%

⚠️ 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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