93451

Insertion of tube in right heart chambers for measurement

Medicare pricing data for 7,040 providers across 52 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $804.41 but Medicare allows only $130.93. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Prices vary significantly by location — from $103 in Idaho to $305 in Arizona. 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

Insertion of tube in right heart chambers for measurement (HCPCS code 93451) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $130.93, but hospitals typically charge $804.41 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$26.19

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $130.93, your out-of-pocket cost would be approximately $26.19. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$130.93
Average Hospital Charge
$804.41
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$804.41
Medicare Allowed$130.93
Medicare Payment$102.81

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $102.81 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$305$1,939167834+132.9%
Nevada$171$1,10852183+30.9%
Kansas$166$1,22773465+27.0%
Texas$162$1,2746563,368+23.7%
Alaska$153$5,1741345+17.0%
Florida$149$8274612,487+13.5%
Louisiana$140$842131482+7.2%
Colorado$134$592121758+2.0%
New York$133$7833602,572+1.4%
Oregon$133$48792431+1.4%
Mississippi$131$96885405-0.1%
Illinois$131$7372922,096-0.3%
Connecticut$131$94396527-0.3%
Missouri$130$908165919-0.7%
Massachusetts$127$5541841,635-2.9%
Pennsylvania$126$6703333,263-3.7%
New Hampshire$125$2,00738303-4.2%
New Jersey$125$869162801-4.5%
Virginia$125$6361971,557-4.6%
Delaware$125$44828219-4.8%
Maryland$122$467901,091-6.6%
Minnesota$122$7501281,215-6.7%
West Virginia$122$48637114-7.1%
New Mexico$121$60428114-7.3%
Michigan$121$6292571,395-7.9%
Montana$120$59927122-8.2%
Wyoming$120$1,607937-8.2%
Vermont$120$592830-8.3%
District of Columbia$120$52720515-8.5%
California$119$6755232,718-8.9%
Georgia$119$7082231,143-8.9%
Ohio$119$7822991,782-9.0%
Oklahoma$119$42979495-9.4%
Maine$118$47030175-9.8%
North Dakota$118$4771681-9.8%
Utah$118$59454362-10.2%
Alabama$117$601123904-11.0%
North Carolina$116$7442211,403-11.6%
Rhode Island$116$60625149-11.7%
Kentucky$115$391108538-12.5%
Washington$113$4081551,029-13.4%
South Dakota$113$6132081-13.7%
Puerto Rico$111$442416-15.0%
Arkansas$111$57784477-15.0%
South Carolina$110$1,625126837-15.7%
Nebraska$109$37637422-16.5%
Iowa$109$76561301-16.7%
Indiana$108$770152858-17.3%
Tennessee$108$3961751,025-17.6%
Wisconsin$105$1,871110749-19.7%
Hawaii$104$4011031-20.7%
Idaho$103$42442168-21.0%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber