C9740

Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants

Medicare pricing data for 384 providers across 39 states

🤖AI Overview

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

Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants (HCPCS code C9740) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $6,914, but hospitals typically charge $20,471 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1,383

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $6,914, your out-of-pocket cost would be approximately $1,383. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$6,914
Average Hospital Charge
$20,471
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$20,471.08
Medicare Allowed$6,914.17
Medicare Payment$5,504.60

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $5,505 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$8,584$29,25045348+24.1%
Hawaii$8,244$14,996227+19.2%
New York$7,750$21,1338121+12.1%
Washington$7,693$15,1456116+11.3%
New Jersey$7,539$27,27812100+9.0%
Massachusetts$7,524$13,831313+8.8%
Oregon$7,380$23,075796+6.7%
Delaware$7,245$12,509249+4.8%
Minnesota$7,167$21,199618+3.7%
Nevada$7,152$20,612422+3.4%
Illinois$7,018$24,836882+1.5%
Pennsylvania$7,006$16,21520358+1.3%
Colorado$6,973$26,0938189+0.9%
Virginia$6,953$14,2569245+0.6%
Maryland$6,945$22,08122765+0.4%
Nebraska$6,943$23,1616117+0.4%
Idaho$6,863$21,064136-0.7%
Texas$6,858$20,14123192-0.8%
Wyoming$6,822$26,967230-1.3%
Indiana$6,811$32,7601251-1.5%
Arizona$6,801$26,72814244-1.6%
Ohio$6,797$11,6618186-1.7%
Georgia$6,768$19,61521425-2.1%
Missouri$6,759$15,2005106-2.2%
Wisconsin$6,738$19,894512-2.6%
Florida$6,640$22,15454943-4.0%
Michigan$6,581$12,810653-4.8%
South Carolina$6,560$14,4398187-5.1%
Kansas$6,514$20,2756104-5.8%
Louisiana$6,504$12,898233-5.9%
Iowa$6,487$20,224329-6.2%
Arkansas$6,474$16,899262-6.4%
South Dakota$6,460$9,858112-6.6%
Kentucky$6,449$14,1925122-6.7%
North Carolina$6,402$31,085231-7.4%
Oklahoma$6,375$21,791375-7.8%
Tennessee$6,342$18,2479214-8.3%
Mississippi$6,247$16,4008301-9.7%
Alabama$6,243$20,760620-9.7%

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

Related from TheDataProject.ai

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