93290

Evaluation of implantable heart and blood vessel monitoring system

Medicare pricing data for 3,795 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $18 in New Mexico to $55 in Hawaii. 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

Evaluation of implantable heart and blood vessel monitoring system (HCPCS code 93290) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $39.83, but hospitals typically charge $108.41 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $39.83, your out-of-pocket cost would be approximately $7.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$39.83
Average Hospital Charge
$108.41
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$108.41
Medicare Allowed$39.83
Medicare Payment$30.04

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $30.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$55$75465+38.9%
District of Columbia$52$1408392+30.8%
New Jersey$50$1611534,545+25.7%
Maryland$48$1091024,364+20.8%
Connecticut$48$15034767+19.9%
Pennsylvania$46$771472,572+15.2%
California$46$974009,430+14.4%
Wyoming$45$123163+14.0%
Puerto Rico$45$5417130+13.9%
Utah$44$90364+11.2%
Nevada$44$7327962+10.8%
Illinois$44$139671,328+10.3%
Colorado$43$10058393+7.2%
New York$42$1983666,828+6.2%
North Dakota$42$76232+6.2%
Alabama$42$741463+5.8%
Florida$42$1025319,634+5.2%
Minnesota$42$15849400+4.3%
Massachusetts$41$111681,997+3.8%
Delaware$41$8626587+3.6%
West Virginia$41$629371+2.5%
Nebraska$41$11621586+1.8%
Louisiana$40$8254452-0.8%
Georgia$39$121791,811-2.2%
New Hampshire$39$1553125-3.0%
North Carolina$38$108772,357-4.6%
Texas$38$1122254,939-5.4%
Oklahoma$38$9238388-5.6%
Wisconsin$37$34829311-6.8%
South Carolina$37$9872807-6.9%
Michigan$37$911331,751-7.7%
Ohio$35$751443,256-12.2%
Indiana$33$70581,176-17.0%
Missouri$33$771241,616-17.9%
Kansas$32$1031272,619-18.7%
Washington$32$9021104-19.6%
Tennessee$32$75712,569-19.6%
Arizona$32$9449538-20.4%
Mississippi$30$6741705-24.1%
Kentucky$30$64611,322-25.9%
Rhode Island$28$5425288-28.8%
Iowa$28$801452-30.7%
Virginia$27$72933,106-31.8%
Arkansas$25$55922,733-38.3%
Idaho$24$6622300-39.2%
New Mexico$18$62162-56.0%

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

Related from TheDataProject.ai

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