82365

Infrared analysis of stone

Medicare pricing data for 186 providers across 35 states

🤖AI Overview

This procedure has a 7.5x markup — hospitals charge $95.18 but Medicare allows only $12.63. Uninsured patients may face bills 7.5 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

Infrared analysis of stone (HCPCS code 82365) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.63, but hospitals typically charge $95.18 — a 7.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.53

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.63, your out-of-pocket cost would be approximately $2.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.63
Average Hospital Charge
$95.18
Markup Ratio
7.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$95.18
Medicare Allowed$12.63
Medicare Payment$12.63

Hospitals charge 7.5x more than what Medicare allows for this procedure. Medicare actually pays $12.63 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$13$96101,664+0.1%
Georgia$13$1102516+0.1%
Hawaii$13$84381+0.1%
Illinois$13$100311,843+0.1%
Iowa$13$54326+0.1%
Kansas$13$1074456+0.1%
Kentucky$13$37270+0.1%
Maryland$13$73587+0.1%
Massachusetts$13$1012327+0.1%
Nevada$13$1001107+0.1%
New Hampshire$13$42529+0.1%
New Mexico$13$95125+0.1%
Oklahoma$13$1114161+0.1%
Pennsylvania$13$1017264+0.1%
South Carolina$13$25281+0.1%
South Dakota$13$58325+0.1%
Tennessee$13$524165+0.1%
Utah$13$344239+0.1%
Virginia$13$715205+0.1%
Alabama$13$51448+0.1%
Colorado$13$815167+0.1%
Connecticut$13$46116+0.1%
Texas$13$105141,1680.0%
California$13$91161,8220.0%
Minnesota$13$1356367-0.1%
New Jersey$13$9161,922-0.1%
New York$13$789642-0.1%
Ohio$13$7410353-0.2%
North Carolina$13$565795-0.2%
Indiana$13$702163-0.4%
Oregon$13$383306-0.4%
Arizona$13$1204702-0.4%
Wisconsin$13$1598317-0.7%
Washington$12$354122-1.6%
Michigan$8$25514-39.5%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber