93460

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

Medicare pricing data for 8,877 providers across 52 states

🤖AI Overview

This procedure has a 5.1x markup — hospitals charge $1,865 but Medicare allows only $364.28. Uninsured patients may face bills 5.1 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 and left heart chambers and coronary artery for diagnosis with review by radiologist (HCPCS code 93460) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $364.28, but hospitals typically charge $1,865 — a 5.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$72.86

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $364.28, your out-of-pocket cost would be approximately $72.86. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$364.28
Average Hospital Charge
$1,865
Markup Ratio
5.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,865.12
Medicare Allowed$364.28
Medicare Payment$288.11

Hospitals charge 5.1x more than what Medicare allows for this procedure. Medicare actually pays $288.11 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$442$9,76715160+21.3%
Arizona$441$2,4772341,664+21.1%
Florida$434$1,5417857,517+19.1%
Louisiana$417$2,6201941,011+14.5%
Kansas$416$5,32978626+14.2%
Oklahoma$412$1,4721261,183+13.2%
Nevada$408$2,47787534+12.1%
Texas$404$3,7369035,437+10.8%
New York$392$1,8864314,849+7.6%
Missouri$388$1,7502331,526+6.5%
District of Columbia$380$1,38821335+4.3%
Connecticut$365$2,04181591+0.2%
Maryland$362$1,419941,216-0.7%
Illinois$361$1,8843432,743-0.9%
New Jersey$357$1,7022592,759-1.9%
Mississippi$356$2,392109761-2.3%
Colorado$353$1,123112710-3.0%
Massachusetts$350$1,4661491,146-3.9%
Delaware$349$1,02326356-4.2%
New Hampshire$348$5,18232294-4.4%
Pennsylvania$347$1,6613414,856-4.7%
Michigan$347$1,3083182,175-4.8%
California$346$1,4827385,786-5.0%
Puerto Rico$343$8293574-5.8%
Virginia$341$1,0542102,190-6.4%
Vermont$340$1,5341036-6.7%
Oregon$340$1,12987620-6.8%
Rhode Island$337$1,34323190-7.4%
Georgia$337$1,7322601,857-7.6%
Ohio$336$1,1563522,452-7.8%
New Mexico$335$1,30129394-8.2%
Montana$334$1,28832274-8.4%
Washington$332$1,0551811,512-8.8%
Wisconsin$330$4,453131778-9.3%
Alabama$330$1,6401731,572-9.5%
Hawaii$329$8921781-9.6%
Maine$328$1,22824133-9.9%
North Carolina$326$1,6892612,399-10.5%
South Carolina$326$2,8681571,327-10.6%
West Virginia$325$1,39349209-10.9%
Wyoming$323$6,29212285-11.4%
Kentucky$323$954122923-11.4%
South Dakota$322$1,17527146-11.7%
Utah$319$1,21856736-12.5%
Nebraska$315$1,08254330-13.6%
Indiana$314$1,1552101,444-13.8%
Tennessee$314$1,0842632,053-13.9%
Idaho$312$1,04334288-14.4%
Minnesota$311$2,241113620-14.6%
North Dakota$308$1,39720233-15.5%
Arkansas$307$1,365113910-15.6%
Iowa$307$1,70566690-15.7%

⚠️ 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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