01940

Anesthesia for nerve destruction procedures on spine or spinal cord of lower back accessed through skin using imaging guidance

Medicare pricing data for 9,916 providers across 52 states

🤖AI Overview

This procedure has a 13.3x markup — hospitals charge $1,463 but Medicare allows only $109.74. Uninsured patients may face bills 13.3 times higher than what insurance negotiates. Prices vary significantly by location — from $74 in Rhode Island to $187 in North Dakota. Where you get this procedure matters more than almost any other factor. 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

Anesthesia for nerve destruction procedures on spine or spinal cord of lower back accessed through skin using imaging guidance (HCPCS code 01940) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $109.74, but hospitals typically charge $1,463 — a 13.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $109.74, your out-of-pocket cost would be approximately $21.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$109.74
Average Hospital Charge
$1,463
Markup Ratio
13.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,462.77
Medicare Allowed$109.74
Medicare Payment$85.93

Hospitals charge 13.3x more than what Medicare allows for this procedure. Medicare actually pays $85.93 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
North Dakota$187$8671120+70.0%
Utah$185$1,668101285+68.9%
Wyoming$173$1,174613+57.3%
Puerto Rico$140$1,740633+27.3%
New Mexico$137$1,12834197+24.8%
Nebraska$131$1,50798453+19.2%
Washington$130$1,30578346+18.3%
Montana$129$996712+17.6%
Virginia$128$1,346114495+16.7%
Oregon$128$1,48675299+16.7%
Alaska$128$1,262514+16.7%
Idaho$128$57045339+16.6%
California$128$1,3926594,613+16.2%
Colorado$124$1,236104645+13.4%
Oklahoma$123$1,20372400+12.5%
South Carolina$123$1,29571270+11.7%
Maryland$121$1,406145728+10.6%
Delaware$120$1,49241184+9.2%
District of Columbia$120$98517101+9.1%
New York$119$2,1647333,162+8.8%
Kansas$119$932110367+8.7%
Nevada$118$1,11549424+7.2%
New Hampshire$118$1,05824173+7.1%
Florida$117$1,5319696,686+6.3%
Indiana$116$873125720+5.3%
Missouri$114$951139395+3.8%
Mississippi$113$54665739+3.0%
Iowa$113$1,34643214+3.0%
Louisiana$113$1,0322701,986+3.0%
Georgia$113$1,8713703,754+2.9%
Tennessee$113$1,1902091,393+2.7%
Massachusetts$112$1,4562201,172+2.2%
Arizona$109$2,4732263,043-0.3%
Arkansas$109$90972938-1.1%
North Carolina$108$1,199192742-1.4%
Hawaii$108$2,82212414-1.8%
Michigan$106$1,4022921,826-3.7%
New Jersey$105$1,3254341,841-4.5%
Minnesota$103$1,324129579-5.7%
Illinois$102$8974402,079-6.7%
Texas$101$1,8111,42510,147-7.5%
Kentucky$101$1,0531001,649-8.0%
Pennsylvania$98$1,0904651,980-11.2%
Wisconsin$97$1,477133502-11.7%
Vermont$96$838211-12.6%
Maine$95$1,10341256-13.3%
Connecticut$94$1,037173611-14.5%
South Dakota$82$57770305-24.9%
Alabama$82$6972911,862-25.2%
West Virginia$81$66852154-26.6%
Ohio$80$6643011,535-27.1%
Rhode Island$74$59137184-32.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber