93456

Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist

Medicare pricing data for 4,397 providers across 50 states

🤖AI Overview

This procedure has a 5.2x markup — hospitals charge $1,571 but Medicare allows only $299.68. Uninsured patients may face bills 5.2 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 right heart chambers and coronary artery for diagnosis with review by radiologist (HCPCS code 93456) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $299.68, but hospitals typically charge $1,571 — a 5.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$59.94

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $299.68, your out-of-pocket cost would be approximately $59.94. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$299.68
Average Hospital Charge
$1,571
Markup Ratio
5.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,570.65
Medicare Allowed$299.68
Medicare Payment$236.45

Hospitals charge 5.2x more than what Medicare allows for this procedure. Medicare actually pays $236.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arizona$492$1,688105424+64.3%
Alaska$361$10,303932+20.6%
Nevada$354$1,3153678+18.2%
Florida$347$1,3223001,065+15.7%
Texas$342$3,1263431,052+14.3%
District of Columbia$327$1,15313315+9.2%
New York$326$2,0022431,777+8.7%
Kansas$322$3,04845103+7.4%
Louisiana$308$1,3956085+2.7%
Illinois$305$1,5912151,021+1.8%
Connecticut$302$1,97955254+0.8%
New Jersey$300$1,239110465-0.0%
Maryland$297$1,22355388-0.9%
Oregon$291$1,12460258-2.9%
Oklahoma$290$87755156-3.2%
Mississippi$290$1,58948122-3.4%
New Mexico$289$9052071-3.4%
California$289$1,5483031,140-3.6%
Pennsylvania$288$1,4632502,266-3.8%
Montana$288$1,1171869-3.8%
Colorado$288$1,17676320-4.0%
Massachusetts$287$1,1991381,145-4.2%
Wyoming$287$5,389740-4.3%
Vermont$286$1,641615-4.5%
Michigan$285$1,074173666-5.0%
Delaware$283$7671888-5.4%
Ohio$283$1,785178773-5.6%
New Hampshire$282$3,69726185-6.0%
Washington$281$862123546-6.1%
Rhode Island$279$1,2361133-6.9%
Georgia$279$1,63189260-7.0%
Virginia$279$944120589-7.0%
Missouri$278$1,19489176-7.1%
Maine$277$1,11332395-7.6%
North Carolina$275$1,253150849-8.3%
Utah$274$1,13442151-8.4%
Alabama$269$1,25273446-10.2%
Iowa$269$1,30238142-10.3%
South Carolina$269$1,80447111-10.4%
Kentucky$265$1,03557153-11.7%
Wisconsin$265$3,83091341-11.7%
North Dakota$264$2,0761336-12.0%
South Dakota$260$2,0441037-13.1%
Arkansas$260$1,1534284-13.2%
Tennessee$260$848134571-13.3%
Minnesota$260$1,53395576-13.3%
Idaho$258$8232592-14.0%
Nebraska$257$8012344-14.2%
West Virginia$257$1,4111935-14.4%
Indiana$257$97283191-14.4%

⚠️ 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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