Procedure Cost Estimator

Estimate the cost of 9,297 medical procedures by state. Compare Medicare payments, hospital charges, and state variation. Data from CMS Medicare Physician Utilization 2023.

Frequently Asked Questions

How are procedure costs estimated? ▼
Costs are based on actual Medicare Physician Utilization data from CMS (2023). The Medicare average payment reflects what Medicare actually paid providers. Submitted charges are the amounts billed by providers before Medicare adjustments.
Why does the same procedure cost different amounts in different states? ▼
Medicare payment rates vary by geographic region due to differences in local cost of living, practice expenses, and malpractice insurance costs. States with higher costs of living generally have higher Medicare reimbursement rates.
What is the difference between Medicare payment and submitted charge? ▼
The submitted charge is what providers bill (the "sticker price"). The Medicare payment is what Medicare actually pays after applying fee schedules and adjustments. The submitted charge is typically 2–4x higher than the Medicare payment. Patients with private insurance may pay amounts closer to the submitted charge.
Are these the out-of-pocket costs I will pay? ▼
No. These are Medicare reimbursement amounts. Your actual cost depends on your insurance plan, deductible, copay, and whether the provider is in-network. Uninsured patients may face the full submitted charge, while Medicare beneficiaries typically pay 20% coinsurance after meeting their deductible.
Data Source: Centers for Medicare & Medicaid Services (CMS), Medicare Physician & Other Practitioners Utilization & Payment Data, Calendar Year 2023.