A9541

Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries

Medicare pricing data for 1,072 providers across 35 states

🤖AI Overview

Prices vary significantly by location — from $65 in Wyoming to $346 in Massachusetts. 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

Technetium tc-99m sulfur colloid, diagnostic, per study dose, up to 20 millicuries (HCPCS code A9541) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $176.39, but hospitals typically charge $319.15 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$35.28

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $176.39, your out-of-pocket cost would be approximately $35.28. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$176.39
Average Hospital Charge
$319.15
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$319.15
Medicare Allowed$176.39
Medicare Payment$140.23

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $140.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Massachusetts$346$36812145+96.1%
Minnesota$305$3631629+72.7%
Arizona$286$52040531+61.9%
Idaho$281$368214+59.3%
Washington$268$37240147+51.9%
Illinois$267$29529164+51.2%
New York$261$47080531+48.1%
California$250$416106777+42.0%
Wisconsin$195$2002641+10.6%
Connecticut$178$2671874+0.8%
Texas$175$34284749-0.9%
Oregon$163$2281957-7.5%
Arkansas$159$3351376-9.9%
Nevada$159$16440192-10.1%
Tennessee$150$28943150-14.7%
Georgia$138$3741668-21.5%
North Carolina$138$29335146-21.9%
Kentucky$133$5171363-24.9%
New Mexico$132$278785-25.3%
Missouri$131$1601890-25.7%
Michigan$127$251722-28.2%
South Carolina$124$152331-30.0%
Indiana$120$326615-32.0%
Iowa$118$410988-33.0%
Kansas$117$18139298-33.7%
Mississippi$117$4491224-34.0%
Nebraska$114$1271160-35.2%
Virginia$107$158745-39.5%
Florida$103$2231451,089-41.5%
Pennsylvania$96$3151755-45.6%
Maryland$90$19034218-49.0%
New Jersey$76$22371350-57.0%
Puerto Rico$70$144841-60.1%
Ohio$67$2491589-62.0%
Wyoming$65$71520-63.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber