Diagnostic procedure preparation cost
What a diagnostic procedure preparation costs across the U.S. — and the fair price to aim for.
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 2.7× Medicare (median 1.53× Fair BaseRate) while upper-quartile commercial rates jump +42% to 2.17× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.09× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- 2-Star CMS clinical rating with 69% patient recommendation (65/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 3.4× markup over Medicare rates
- Commercial insurance median sits at 1.53× Fair BaseRate (2.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.17×) jump +42% above the median procedure ratio (Q50 1.53×)
- Consolidated metro market (HHI 2,705) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
National State Price Index Heatmap · Diagnostic procedure preparation
State commercial price index vs. U.S. median (1.00×) and average Medicare multiple across all 53 priced states & territories
Across 1,898 hospitals in 50 states, a diagnostic procedure preparation has a fair BaseRate of $35 and typically costs $13–$80. The cheapest state is SC; the priciest is DC.
Cheapest hospitals for a diagnostic procedure preparation
- Valley View Medical Center · Fort Mohave, AZ $10
- Saint Francis Medical Center · Cape Girardeau, MO $10
- Mercy Hospital Fort Smith · Fort Smith, AR $11
- Mercy Hospital Northwest Arkansas · Rogers, AR $11
- Mercy Hospital Lebanon · Lebanon, MO $11
- Mercy Hospital Washington · Washington, MO $11
- Mercy Hospital Joplin · Joplin, MO $11
- Ouachita County Medical Center · Camden, AR $11
- Iberia Medical Center · New Iberia, LA $11
- Mon Health Medical Center · Morgantown, WV $11
- Cullman Regional Medical Center · Cullman, AL $11
- Belton Regional Medical Center · Belton, MO $11
- Medical West, An Affiliate of UAB Health System · Bessemer, AL $11
- Mercy Hospital Oklahoma City, Inc · Oklahoma City, OK $11
- Mercy Hospital Ardmore, Inc · Ardmore, OK $11
Diagnostic procedure preparation cost by state
Audit a Bill or Quote at U.S. Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $30
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $30).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask U.S. Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $35 Fair BaseRate ($20 Medicare)
Your bill ($84) is $49 above the denoised Fair BaseRate ($35) and 4.2× the $20 Medicare rate.