93454

Insertion of tube in coronary artery for diagnosis with review by radiologist

Medicare pricing data for 8,918 providers across 52 states

🤖AI Overview

This procedure has a 5.9x markup — hospitals charge $1,214 but Medicare allows only $205.97. Uninsured patients may face bills 5.9 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

Insertion of tube in coronary artery for diagnosis with review by radiologist (HCPCS code 93454) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $205.97, but hospitals typically charge $1,214 — a 5.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$41.19

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $205.97, your out-of-pocket cost would be approximately $41.19. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$205.97
Average Hospital Charge
$1,214
Markup Ratio
5.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,213.76
Medicare Allowed$205.97
Medicare Payment$161.94

Hospitals charge 5.9x more than what Medicare allows for this procedure. Medicare actually pays $161.94 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$317$1,6422363,231+53.7%
Louisiana$276$1,6692342,042+33.8%
Alaska$247$6,47321321+20.0%
Oklahoma$237$8261511,183+15.2%
Texas$236$1,8668606,518+14.7%
Nevada$229$1,84984767+11.1%
Florida$227$9636917,084+10.0%
New York$223$1,2874236,316+8.2%
Kansas$220$1,764912,000+6.7%
Nebraska$215$83769839+4.5%
District of Columbia$215$85221576+4.2%
Mississippi$210$1,1761011,279+1.8%
Oregon$206$9781041,363-0.2%
Maryland$204$799872,399-1.1%
Connecticut$203$1,610791,033-1.5%
Michigan$203$8473132,623-1.6%
Illinois$202$1,2043624,766-2.0%
Massachusetts$201$9731784,509-2.4%
New Jersey$201$1,1872252,438-2.6%
Vermont$198$1,14811376-3.8%
Montana$197$89335630-4.4%
Ohio$196$1,2943674,098-5.1%
Pennsylvania$195$1,2173385,576-5.2%
Georgia$194$1,2002191,681-5.6%
Delaware$194$56824428-5.8%
New Hampshire$194$1,41838876-6.0%
Washington$193$7052082,140-6.5%
Colorado$191$8371331,622-7.1%
Arkansas$191$7631431,262-7.3%
Missouri$191$9392171,919-7.5%
California$190$1,1777589,539-7.7%
South Dakota$190$1,52833974-7.9%
Virginia$189$8062102,630-8.0%
Maine$187$96033592-9.2%
South Carolina$187$1,3651491,326-9.3%
Rhode Island$183$94722176-11.1%
Minnesota$183$1,2361253,353-11.3%
North Carolina$183$9432272,587-11.3%
Kentucky$182$6321481,507-11.5%
West Virginia$182$94954493-11.8%
Utah$182$82263601-11.9%
Alabama$181$1,0141531,254-12.0%
Iowa$181$861771,805-12.1%
Indiana$180$8742052,425-12.5%
North Dakota$178$1,01521541-13.7%
Wyoming$177$3,355822-13.9%
Wisconsin$177$2,9741562,571-14.2%
Tennessee$176$6922441,860-14.7%
Puerto Rico$175$598635-14.8%
New Mexico$171$1,23135252-17.1%
Idaho$170$65843622-17.4%
Hawaii$167$6391369-19.1%

⚠️ 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