Medical & Financial Disclaimer

Informational Use Only

The information on PlainProcedure — including Medicare payments, submitted charges, markup ratios, and estimated commercial and cash prices — is provided for general educational purposes. It is not medical, financial, billing, insurance, or legal advice, and it is not a recommendation for or against any procedure, provider, hospital, or insurance plan. Always consult a qualified physician about your care and a qualified professional about a specific bill or coverage question.

Prices Are Benchmarks, Not Quotes

Medicare payment and submitted-charge figures are national or state averages from CMS data, not the price for any specific patient or visit. The estimated commercial and cash prices are derived from published price ratios (see our methodology and editorial policy) and will differ from what any particular insurer, hospital, or self-pay patient actually pays. What you owe depends on your coverage, deductible, your provider's negotiated rates, and your individual circumstances. For an enforceable price, request a Good Faith Estimate from your provider.

Data Limitations

The data reflects Medicare Part B fee-for-service claims for the published year (currently 2023) and does not include Medicare Advantage, inpatient (MS-DRG) claims, or capitated care. Some low-payment drug- and vaccine-administration codes produce extreme billed-to-paid ratios that are statistical artifacts rather than meaningful markups; we exclude these from "typical markup" figures. Figures may contain errors inherent in the source data or our processing of it — if you spot one, please tell us and see how we handle corrections in our editorial & corrections policy.

No Affiliation or Endorsement

PlainProcedure is an independent publisher. It is not affiliated with, endorsed by, or sponsored by CMS, Medicare, the U.S. government, or any hospital, provider, or insurer. References to organizations and datasets are for identification and attribution only.