97610

Therapy procedure using ultrasound

Medicare pricing data for 1,335 providers across 38 states

🤖AI Overview

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

Therapy procedure using ultrasound (HCPCS code 97610) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $432.80, but hospitals typically charge $970.46 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$86.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $432.80, your out-of-pocket cost would be approximately $86.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$432.80
Average Hospital Charge
$970.46
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$970.46
Medicare Allowed$432.80
Medicare Payment$343.54

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $343.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$539$7293344+24.4%
Massachusetts$524$75841,597+21.2%
California$490$1,19320527,287+13.3%
New York$471$965672,322+8.9%
Connecticut$456$9649646+5.4%
Pennsylvania$447$802694,158+3.2%
New Jersey$447$1,3508918,413+3.2%
Virginia$446$89720195+2.9%
Washington$443$739211,531+2.3%
Illinois$439$793859,446+1.5%
Nebraska$424$1,6544249-2.0%
Oregon$423$5139371-2.3%
Ohio$422$1,3786631-2.4%
Hawaii$419$1,047765-3.1%
Colorado$414$837271,541-4.3%
Delaware$414$7066255-4.4%
Missouri$412$93010438-4.9%
North Carolina$409$72022679-5.4%
South Carolina$397$6126199-8.3%
Utah$391$812251,812-9.6%
Texas$390$738987,920-9.8%
Florida$390$6261105,799-9.9%
Nevada$383$670233,693-11.5%
Arizona$382$7288011,381-11.7%
Georgia$380$87613422-12.1%
Indiana$379$8148381-12.4%
New Mexico$376$6808226-13.2%
Michigan$373$85715549-13.8%
Wisconsin$373$96911671-13.9%
Oklahoma$372$883271,623-14.0%
Alabama$372$46810268-14.1%
Kansas$369$70161,241-14.8%
Idaho$366$62914833-15.5%
Maryland$356$56518107-17.9%
Louisiana$332$959381,289-23.3%
Minnesota$325$65746918-24.8%
Mississippi$324$90116355-25.1%
Tennessee$319$6631974-26.3%

⚠️ 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

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