20550

Injection into tendon or ligament

Medicare pricing data for 48,444 providers across 52 states

🤖AI Overview

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

Injection into tendon or ligament (HCPCS code 20550) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.35, but hospitals typically charge $191.57 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.35, your out-of-pocket cost would be approximately $10.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.35
Average Hospital Charge
$191.57
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$191.57
Medicare Allowed$51.35
Medicare Payment$38.02

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $38.02 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$61$2522,79854,197+19.6%
Alaska$61$356134911+18.0%
New Jersey$60$2121,74137,412+16.9%
Connecticut$56$2395528,311+9.5%
Maryland$56$15995419,090+8.1%
District of Columbia$55$173881,504+7.9%
California$54$1964,09078,048+4.5%
Puerto Rico$53$66116790+3.4%
Illinois$53$2131,81625,437+2.4%
Colorado$53$2139319,313+2.2%
Pennsylvania$52$1692,55138,651+2.1%
Massachusetts$52$2121,03220,176+0.4%
Delaware$52$2231533,759+0.4%
Florida$51$1793,55288,856+0.3%
Hawaii$51$1361542,015+0.2%
Washington$51$1671,08213,286-0.2%
Texas$51$1793,16944,171-0.5%
Virginia$51$1931,33024,362-0.6%
Nevada$51$2653805,980-0.6%
Michigan$50$1401,49216,661-2.0%
Oregon$50$1766516,165-2.4%
Rhode Island$50$1911782,760-3.4%
Georgia$50$1961,39922,209-3.5%
New Mexico$50$1622934,074-3.6%
Oklahoma$49$1304815,966-3.7%
South Carolina$49$15782015,990-4.1%
New Hampshire$49$2142463,601-4.4%
Kentucky$49$1546387,596-5.5%
Montana$48$1482242,706-5.9%
Utah$48$1485435,143-6.1%
Wyoming$48$2031261,258-6.2%
North Carolina$48$1831,77824,804-6.4%
Indiana$48$1781,12512,656-6.8%
Mississippi$47$1973796,429-8.0%
Tennessee$47$1851,09615,335-8.0%
Alabama$47$1186368,936-8.1%
Arkansas$47$1563905,482-8.4%
Ohio$47$1701,94823,682-8.6%
Kansas$46$2154926,110-9.8%
Iowa$46$2095166,709-10.2%
Maine$45$1261861,649-11.6%
Wisconsin$45$3579578,355-11.8%
Missouri$45$21095015,012-11.9%
Minnesota$45$2018968,386-13.2%
Arizona$44$1931,10925,632-13.9%
Nebraska$44$1773814,157-14.3%
West Virginia$44$1542493,108-14.9%
Louisiana$43$17973913,041-15.4%
Idaho$43$1423863,298-15.8%
South Dakota$40$1812402,454-21.8%
North Dakota$39$1801631,530-24.0%
Vermont$39$154931,012-24.7%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber