Delaware · 36573

Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Delaware

Delaware Medicare Avg
$64.78
15% below national avg
National Medicare Avg
$76.18
All states combined
Billed Charge (DE)
$300.63
What providers submit
Est. Commercial (DE)
$185.30
National avg: $216.70
Est. Cash / Self-Pay (DE)
$144.44
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

69
Services in DE
18
Providers
N/A
Min Payment
N/A
Max Payment

Delaware Pricing in Context

In Delaware, CPT code 36573 (Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older) carries an average Medicare payment of $64.78 — 15% below the national benchmark of $76.18. 18 providers across the state submitted claims for this procedure in 2023, performing 69 total services. Individual payments in DE ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Delaware is $300.63, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Delaware sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Cardiovascular Surgery procedures, the estimated commercial insurance price in Delaware lands near $185.30, with self-pay cash prices typically around $144.44. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cost in Delaware?

The average Medicare payment for Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Delaware is $64.78, which is 15% below the national average of $76.18. Providers in DE typically bill $300.63 for this procedure.

What does Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cost with insurance in Delaware?

With commercial insurance in Delaware, Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older costs an estimated $185.30. Without insurance, the estimated cash price is $144.44. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Delaware?

18 providers in Delaware billed Medicare for Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in 2023, performing 69 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cheaper in Delaware than the national average?

Yes — Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older costs 15% below the national average in Delaware. The state average Medicare payment is $64.78 compared to $76.18 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial