76998

Ultrasonic guidance during surgery

Medicare pricing data for 4,950 providers across 51 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

Ultrasonic guidance during surgery (HCPCS code 76998) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $66.66, but hospitals typically charge $278.26 — a 4.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.33

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $66.66, your out-of-pocket cost would be approximately $13.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$66.66
Average Hospital Charge
$278.26
Markup Ratio
4.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$278.26
Medicare Allowed$66.66
Medicare Payment$53.06

Hospitals charge 4.2x more than what Medicare allows for this procedure. Medicare actually pays $53.06 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$99$363119825+47.8%
Texas$81$3283913,021+20.9%
Kansas$77$21752276+15.5%
New York$75$3903131,679+12.6%
Florida$72$2503302,471+8.1%
Alaska$72$5551368+7.3%
New Jersey$70$400129499+4.4%
Illinois$69$2682111,024+3.7%
District of Columbia$67$2891465+0.2%
California$66$2485023,474-0.8%
Oklahoma$65$23552433-2.6%
Massachusetts$63$253184891-4.8%
Connecticut$63$20660162-5.0%
Virginia$63$208117794-5.2%
Colorado$63$35578269-5.2%
Missouri$63$29999563-6.2%
Louisiana$62$33080339-6.3%
Pennsylvania$62$233229973-6.4%
Michigan$62$297120412-7.5%
Washington$61$208117717-8.3%
Georgia$61$2751371,128-8.8%
Ohio$61$231158846-9.0%
West Virginia$61$2291273-9.2%
New Hampshire$60$34438325-9.5%
Rhode Island$60$2011754-9.8%
South Carolina$60$39482690-10.3%
New Mexico$60$2871755-10.4%
Delaware$60$2621479-10.5%
Minnesota$60$348127519-10.6%
North Carolina$59$229129524-10.8%
Arizona$59$216125890-11.0%
Wyoming$59$248513-11.5%
Oregon$59$19175367-11.9%
Utah$59$33843157-12.1%
Hawaii$58$42412144-13.1%
Kentucky$58$15536179-13.1%
Maine$58$2412565-13.4%
North Dakota$58$188920-13.4%
Vermont$57$2891580-13.8%
Indiana$57$25292643-13.8%
Wisconsin$57$384116644-13.9%
Idaho$57$2211983-14.0%
Alabama$57$26256420-15.2%
Tennessee$56$216114662-15.3%
South Dakota$56$1611220-15.4%
Nevada$56$22029295-16.3%
Iowa$56$22555322-16.4%
Mississippi$56$1722088-16.6%
Arkansas$55$20028176-16.8%
Nebraska$55$16752486-17.6%
Montana$54$1881542-18.6%

⚠️ 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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