78195

Nuclear medicine study of lymphatic system

Medicare pricing data for 4,997 providers across 52 states

🤖AI Overview

This procedure has a 5.3x markup — hospitals charge $347.12 but Medicare allows only $65.31. Uninsured patients may face bills 5.3 times higher than what insurance negotiates. Prices vary significantly by location — from $49 in Idaho to $139 in Puerto Rico. 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

Nuclear medicine study of lymphatic system (HCPCS code 78195) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $65.31, but hospitals typically charge $347.12 — a 5.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $65.31, your out-of-pocket cost would be approximately $13.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$65.31
Average Hospital Charge
$347.12
Markup Ratio
5.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$347.12
Medicare Allowed$65.31
Medicare Payment$51.04

Hospitals charge 5.3x more than what Medicare allows for this procedure. Medicare actually pays $51.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$139$1861329+113.5%
Nebraska$115$52347167+75.9%
New Jersey$96$505116579+47.4%
Kansas$93$24162205+42.2%
California$82$4024612,789+25.1%
Washington$80$264102545+23.2%
Arizona$76$61071265+16.9%
Alaska$72$3471439+9.6%
Arkansas$70$29045176+7.5%
Florida$70$4864012,489+7.1%
New York$69$3622271,553+6.2%
Illinois$67$4052691,352+2.5%
Maryland$67$22288637+2.1%
Tennessee$64$267142775-2.5%
Texas$63$3933341,765-3.0%
District of Columbia$60$24919159-8.3%
Ohio$59$331167585-9.6%
Connecticut$58$21144154-11.1%
Massachusetts$58$211106521-11.9%
Rhode Island$57$21915140-12.9%
Missouri$57$263128746-13.0%
Pennsylvania$56$273168738-14.1%
Delaware$56$361541-14.3%
Colorado$56$25655217-14.5%
New Hampshire$56$29037128-14.7%
Michigan$55$272141636-15.1%
New Mexico$55$20423215-15.2%
Oregon$55$18346179-15.5%
Georgia$55$377177652-15.6%
Virginia$55$241125693-15.8%
North Dakota$55$25917103-16.0%
Minnesota$55$263117337-16.1%
Wyoming$55$4061330-16.3%
Nevada$55$5203986-16.5%
Hawaii$55$2192387-16.5%
South Dakota$54$2041970-17.2%
Montana$54$19436117-17.2%
Louisiana$54$38861209-17.4%
North Carolina$54$288145842-17.5%
West Virginia$54$29544135-17.7%
Vermont$54$307829-17.7%
Maine$54$2002571-17.7%
Kentucky$54$15845187-18.0%
Indiana$53$26394363-18.1%
Alabama$53$164119468-18.2%
South Carolina$53$34397477-18.3%
Wisconsin$53$584141447-18.3%
Iowa$53$23169206-18.5%
Oklahoma$53$26365262-18.6%
Mississippi$52$32366487-19.7%
Utah$51$2441773-21.8%
Idaho$49$32750151-24.4%

⚠️ 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