97035

Application of ultrasound, each 15 minutes

Medicare pricing data for 26,543 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.2 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Application of ultrasound, each 15 minutes (HCPCS code 97035) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $10.90, but hospitals typically charge $37.22 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $10.90, your out-of-pocket cost would be approximately $2.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$10.90
Average Hospital Charge
$37.22
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$37.22
Medicare Allowed$10.90
Medicare Payment$8.42

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $8.42 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$14$48201,638+32.0%
Alaska$14$661031,792+30.5%
New York$12$411,639133,235+10.0%
New Jersey$12$451,01549,390+7.2%
California$12$332,234178,719+6.8%
Connecticut$11$4329512,250+3.9%
Massachusetts$11$3742117,900+3.7%
Rhode Island$11$411235,606+3.4%
Georgia$11$3963732,986+3.3%
Maryland$11$3367628,814+1.7%
Illinois$11$461,35446,455+0.1%
Nevada$11$501964,837-0.3%
Michigan$11$511,01739,316-0.8%
Colorado$11$3851213,213-1.0%
Washington$11$2970320,028-1.1%
North Dakota$11$3621711,052-1.7%
Hawaii$11$34961,754-2.0%
Arizona$11$3054727,200-2.0%
Virginia$11$3970620,662-2.1%
Delaware$11$521604,089-2.3%
New Hampshire$11$371485,300-2.3%
Montana$11$311874,844-2.4%
Florida$11$341,40996,657-3.0%
Minnesota$11$4660414,112-3.0%
Vermont$11$311277,070-3.1%
Pennsylvania$11$381,01655,837-3.2%
Wyoming$11$3525110,868-3.2%
Texas$11$3593535,180-3.6%
Puerto Rico$11$1715414,076-3.7%
Oregon$10$373218,870-4.2%
South Dakota$10$562097,502-4.2%
Utah$10$2420113,905-4.3%
Maine$10$331423,304-4.8%
Wisconsin$10$6574312,142-4.8%
Louisiana$10$3539327,312-5.0%
Ohio$10$3760616,530-6.1%
Missouri$10$3848718,449-6.2%
New Mexico$10$341224,569-6.5%
South Carolina$10$3644415,913-6.5%
Indiana$10$3865516,141-6.8%
North Carolina$10$3167020,901-6.9%
Kentucky$10$3734511,889-7.2%
Kansas$10$3133710,406-7.6%
Idaho$10$241968,360-7.7%
Nebraska$10$3338022,372-7.9%
Iowa$10$3956614,037-8.1%
Mississippi$10$3431710,127-8.4%
Oklahoma$10$3426410,276-8.7%
Arkansas$10$3429920,489-9.1%
West Virginia$10$361756,225-9.2%
Alabama$10$3257725,452-9.3%
Tennessee$10$3357320,250-9.5%

⚠️ 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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