Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito
Medicare pricing data for 5,601 providers across 52 states
This procedure has a 16.1x markup — hospitals charge $118.02 but Medicare allows only $7.35. Uninsured patients may face bills 16.1 times higher than what insurance negotiates. Prices vary significantly by location — from $5 in Arkansas to $52 in Puerto Rico. Where you get this procedure matters more than almost any other factor. 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
Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito (HCPCS code G0500) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.35, but hospitals typically charge $118.02 — a 16.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.35, your out-of-pocket cost would be approximately $1.47. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 16.1x more than what Medicare allows for this procedure. Medicare actually pays $5.65 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Puerto Rico | $52 | $55 | 112 | 2,271 | +610.2% |
| West Virginia | $19 | $98 | 12 | 823 | +162.2% |
| Nevada | $14 | $91 | 20 | 417 | +88.0% |
| South Dakota | $12 | $124 | 17 | 298 | +66.8% |
| New York | $10 | $72 | 353 | 13,972 | +42.3% |
| Virginia | $9 | $123 | 63 | 1,647 | +28.0% |
| Montana | $9 | $102 | 20 | 633 | +19.9% |
| Minnesota | $9 | $103 | 335 | 11,937 | +19.5% |
| Michigan | $9 | $65 | 257 | 6,907 | +17.4% |
| New Jersey | $8 | $230 | 25 | 1,540 | +11.6% |
| California | $8 | $154 | 1,099 | 65,047 | +11.3% |
| Oklahoma | $8 | $143 | 31 | 801 | +2.3% |
| Alaska | $7 | $126 | 20 | 1,995 | -1.1% |
| Illinois | $7 | $145 | 375 | 13,488 | -3.4% |
| Florida | $7 | $140 | 92 | 2,907 | -7.5% |
| Texas | $7 | $125 | 126 | 4,502 | -11.3% |
| Colorado | $6 | $57 | 133 | 5,061 | -13.6% |
| Wisconsin | $6 | $195 | 192 | 8,000 | -17.3% |
| North Carolina | $6 | $87 | 71 | 4,113 | -20.8% |
| Tennessee | $6 | $149 | 13 | 587 | -22.2% |
| Louisiana | $6 | $123 | 37 | 1,715 | -22.3% |
| Massachusetts | $6 | $91 | 353 | 14,046 | -23.4% |
| Washington | $6 | $47 | 243 | 9,775 | -23.8% |
| Missouri | $6 | $63 | 68 | 4,161 | -24.8% |
| Connecticut | $5 | $162 | 12 | 653 | -25.9% |
| Ohio | $5 | $102 | 398 | 10,298 | -26.3% |
| Arizona | $5 | $203 | 62 | 3,623 | -26.3% |
| Rhode Island | $5 | $90 | 51 | 2,661 | -26.4% |
| District of Columbia | $5 | $51 | 9 | 87 | -27.1% |
| New Hampshire | $5 | $114 | 60 | 3,788 | -27.1% |
| Maryland | $5 | $131 | 10 | 785 | -27.2% |
| New Mexico | $5 | $103 | 49 | 3,137 | -27.3% |
| Pennsylvania | $5 | $78 | 51 | 2,209 | -27.5% |
| Maine | $5 | $64 | 33 | 2,283 | -27.9% |
| Wyoming | $5 | $30 | 2 | 83 | -28.2% |
| Hawaii | $5 | $79 | 21 | 476 | -28.3% |
| Georgia | $5 | $162 | 34 | 1,397 | -28.4% |
| South Carolina | $5 | $130 | 23 | 313 | -28.6% |
| Oregon | $5 | $99 | 105 | 2,718 | -29.5% |
| Kentucky | $5 | $34 | 30 | 1,113 | -29.7% |
| Utah | $5 | $151 | 57 | 3,466 | -29.7% |
| Delaware | $5 | $87 | 4 | 20 | -29.9% |
| Idaho | $5 | $97 | 44 | 5,301 | -30.2% |
| Alabama | $5 | $116 | 12 | 331 | -30.7% |
| North Dakota | $5 | $157 | 27 | 1,196 | -31.2% |
| Vermont | $5 | $122 | 39 | 3,260 | -31.4% |
| Indiana | $5 | $74 | 117 | 8,695 | -31.8% |
| Mississippi | $5 | $85 | 5 | 109 | -32.4% |
| Kansas | $5 | $63 | 18 | 96 | -32.5% |
| Iowa | $5 | $122 | 140 | 13,170 | -33.7% |
| Nebraska | $5 | $146 | 46 | 1,215 | -34.6% |
| Arkansas | $5 | $99 | 55 | 1,808 | -34.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber