A9505

Thallium tl-201 thallous chloride, diagnostic, per millicurie

Medicare pricing data for 95 providers across 5 states

🤖AI Overview

Prices vary significantly by location — from $35 in Georgia to $73 in Florida. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Thallium tl-201 thallous chloride, diagnostic, per millicurie (HCPCS code A9505) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $57.72, but hospitals typically charge $162.34 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.54

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $57.72, your out-of-pocket cost would be approximately $11.54. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$57.72
Average Hospital Charge
$162.34
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$162.34
Medicare Allowed$57.72
Medicare Payment$46.01

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $46.01 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Florida$73$10824917+26.6%
New York$57$119757-0.6%
California$57$168296,777-2.0%
Illinois$36$100118-37.9%
Georgia$35$21618218-40.0%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber