Price reports for G0402 Initial preventive exam

Community member

Price charged

$155.00

Insurance paid

$0.00

You paid

$155.00

Provider: Unniversity Hospitals
Address: Cleveland, 11100 Euclid Avenue, OH
Community member

Price charged

$189.00

Insurance paid

$66.52

You paid

$0.00

Facility fee was 267.46, more than the fee for the doctor.
Provider: Tuulane University Hospital and Clinic
Address: New Orleans, ,, LA
Community member

Price charged

$275.00

Insurance paid

$205.00

You paid

$0.00

Insurer: Humana
Provider: Leevin's Women's Health & Wellness Center
Address: North Miami, 12550, Biscayne Boulevard, FL
Community member

Price charged

$3,526.53

Insurance paid

$2,875.64

You paid

$650.89

The $3,526.53 includes an ultrasound (0402) and screening mammography (0403). They put both charges together. I've been battling NYU Langone stating that my annual mammogram and annual sonogram (as I have dense breast issue and a family history). They continue to tell me that given the sonogram is diagnostic because of my dense tissue that the charge is as stated. I've had much worse insurance than the current Cigna plan in the past and both have always been covered, for many years. In addition to the $650.89, I am also being billed $139.52 from NYU Langone Physician Services - the hospital has been unable to explain why I am being charged by a physician when this should be in-network. I get my insurance through my husband's company ($700 a month family plan vs. what my company would charge, $1,800 month United Healthcare equivalent family plan). On top of all of this, his company contracts a firm, Alight Services/Compass, to help with billing disputes like this - they've made matters worse and created even more confusion. I'm wondering of they are in cahoots. It seems like many people are making money off of a fearful and confusing system that has to change. Going forward, I am going to discuss whether or not I really need a mammogram and ultrasound every year despite my family history.
Insurer: Cigna
Provider: NYYU Langone Health
Address: New York, 550, 1st Avenue, NY

What Medicare pays here?

Initial preventive exam
Region Price
Alabama $122.31
Alaska $175.45
Arizona $127.08
Arkansas $122.11
Anaheim/Santa Ana, CA $138.98
Los Angeles, CA $135.79
Marin/Napa/Solano, CA $139.48
Oakland/Berkeley, CA $140.64
Rest of California $131.74
San Francisco, CA $145.68
San Mateo, CA $145.47
Santa Clara, CA $145.29
Ventura, CA $136.82
Colorado $129.90
Connecticut $136.27
DC + MD/VA Suburbs $141.76
Delaware $130.96
Fort Lauderdale, FL $133.76
Miami, FL $138.53
Rest of Florida $129.23
Atlanta, GA $129.39
Rest of Georgia $125.77
Hawaii/Guam $132.95
Idaho $122.85
Chicago, IL $135.95
East St. Louis, IL $130.96
Rest of Illinois $127.23
Suburban Chicago, IL $134.77
Indiana $122.74
Iowa $122.55
Kansas $123.73
Kentucky $123.72
New Orleans, LA $129.27
Rest of Louisiana $126.02
Rest of Maine $124.42
Southern Maine $127.49
Baltimore/Surr. Cntys, MD $136.05
Rest of Maryland $131.44
Metropolitan Boston $134.48
Rest of Massachusetts $133.52
Detroit, MI $132.36
Rest of Michigan $126.20
Minnesota $125.97
Mississippi $120.93
Metropolitan Kansas City, MO $128.08
Metropolitan St Louis, MO $127.83
Rest of Missouri $124.04
Montana $132.43
Nebraska $122.09
Nevada $129.32
New Hampshire $130.91
Northern NJ $138.76
Rest of New Jersey $135.22
New Mexico $127.51
Manhattan, NY $143.39
NYC Suburbs/Long I., NY $146.21
Poughkpsie/N NYC Suburbs, NY $134.64
Queens, NY $146.84
Rest of New York $125.03
North Carolina $124.88
North Dakota $126.53
Ohio $126.06
Oklahoma $124.84
Portland, OR $130.67
Rest of Oregon $126.66
Metropolitan Philadelphia, PA $135.66
Rest of Pennsylvania $126.89
Puerto Rico $129.22
Rhode Island $133.18
South Carolina $123.43
South Dakota $125.72
Tennessee $122.89
Austin, TX $128.41
Beaumont, TX $125.41
Brazoria, TX $129.79
Dallas, TX $129.32
Fort Worth, TX $127.76
Galveston, TX $130.30
Houston, TX $130.86
Rest of Texas $125.68
Utah $127.28
Vermont $127.37
Virgin Islands $129.22
Virginia $128.02
Rest of Washington $128.89
Seattle (King Cnty), WA $136.27
West Virginia $125.47
Wisconsin $123.94
Wyoming $128.37
Bakersfield, CA $131.37
Chico, CA $131.07
El Centro, CA $131.11
Fresno, CA $131.07
Hanford-Corcoran, CA $131.16
Los Angeles-Long Beach-Anaheim (Los Angeles Cnty), CA $137.77
Los Angeles-Long Beach-Anaheim (Orange Cnty), CA $137.77
Madera, CA $131.07
Merced, CA $131.07
Modesto, CA $131.07
Napa, CA $140.13
Oxnard-Thousand Oaks-Ventura, CA $135.70
Redding, CA $131.07
Riverside-San Bernardino-Ontario, CA $132.19
Sacramento--Roseville--Arden-Arcade, CA $132.33
Salinas, CA $132.57
San Diego-Carlsbad, CA $132.89
San Francisco-Oakland-Hayward (Alameda/Contra Costa Cnty), CA $144.17
San Francisco-Oakland-Hayward (Marin Cnty), CA $142.27
San Francisco-Oakland-Hayward (San Francisco Cnty), CA $144.17
San Francisco-Oakland-Hayward (San Mateo Cnty), CA $144.17
San Jose-Sunnyvale-Santa Clara (San Benito Cnty), CA $138.92
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty), CA $145.74
San Luis Obispo-Paso Robles-Arroyo Grande, CA $131.43
Santa Cruz-Watsonville, CA $135.08
Santa Maria-Santa Barbara, CA $134.00
Santa Rosa, CA $133.44
Stockton-Lodi, CA $131.07
Vallejo-Fairfield, CA $140.13
Visalia-Porterville, CA $131.07
Yuba City, CA $131.07
Rest Of California, CA $131.07
Hawaii, GUam $132.28
Metropolitan Boston, MA $138.69