High energy shock wave therapy of musculoskeletal system
Medicare pricing data for 133 providers across 15 states
Prices vary significantly by location — from $14 in Utah to $347 in Massachusetts. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
High energy shock wave therapy of musculoskeletal system (HCPCS code 0101T) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $277.26, but hospitals typically charge $461.82 — a 1.7x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $277.26, your out-of-pocket cost would be approximately $55.45. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $218.60 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Massachusetts | $347 | $751 | 3 | 58 | +25.3% |
| New York | $338 | $436 | 20 | 1,426 | +22.0% |
| New Jersey | $337 | $487 | 12 | 2,241 | +21.6% |
| Kansas | $315 | $500 | 1 | 49 | +13.5% |
| Puerto Rico | $308 | $322 | 2 | 111 | +11.0% |
| Colorado | $269 | $357 | 4 | 61 | -3.1% |
| Florida | $263 | $573 | 14 | 918 | -5.0% |
| Texas | $258 | $502 | 24 | 3,448 | -6.9% |
| Arkansas | $236 | $398 | 5 | 624 | -15.0% |
| Nebraska | $207 | $219 | 3 | 290 | -25.4% |
| Minnesota | $157 | $168 | 2 | 43 | -43.2% |
| Illinois | $148 | $150 | 1 | 379 | -46.8% |
| Arizona | $14 | $226 | 6 | 66 | -95.0% |
| California | $14 | $226 | 4 | 36 | -95.1% |
| Utah | $14 | $69 | 6 | 42 | -95.1% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber