20552

Injection of trigger points, 1-2 muscles

Medicare pricing data for 29,700 providers across 52 states

🤖AI Overview

This procedure has a 5.2x markup — hospitals charge $234.75 but Medicare allows only $45.35. Uninsured patients may face bills 5.2 times higher than what insurance negotiates. 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 of trigger points, 1-2 muscles (HCPCS code 20552) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $45.35, but hospitals typically charge $234.75 — a 5.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.07

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $45.35, your out-of-pocket cost would be approximately $9.07. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$45.35
Average Hospital Charge
$234.75
Markup Ratio
5.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$234.75
Medicare Allowed$45.35
Medicare Payment$34.28

Hospitals charge 5.2x more than what Medicare allows for this procedure. Medicare actually pays $34.28 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$57$43089432+24.6%
New York$55$2771,37920,820+20.8%
New Jersey$53$4617759,111+16.0%
Connecticut$51$2202402,863+13.4%
District of Columbia$50$15444161+10.9%
Puerto Rico$50$5850228+9.7%
Delaware$48$226851,116+6.5%
California$48$4232,59628,039+6.2%
Maryland$48$2005205,286+5.3%
Florida$47$1962,38629,268+4.3%
Hawaii$46$12947206+1.3%
Nevada$46$2752813,075+1.2%
Virginia$45$17295611,659+0.1%
New Hampshire$45$233123975-1.0%
Oregon$45$1793211,509-1.1%
Illinois$45$2418108,659-1.2%
Michigan$45$1696714,796-1.2%
Colorado$45$2325653,300-1.6%
Louisiana$45$2354473,252-1.8%
Pennsylvania$45$1611,43013,193-1.8%
Washington$44$1725222,957-1.9%
Wyoming$44$27676388-2.0%
Maine$44$14285950-2.2%
Texas$44$2261,80513,051-2.5%
South Carolina$44$1536344,825-3.0%
Georgia$44$2571,23513,466-3.7%
Oklahoma$43$1393572,382-4.9%
Alabama$43$1196456,969-5.0%
North Carolina$43$1791,53412,988-5.4%
Utah$43$1373811,900-5.5%
Tennessee$43$1559748,042-6.3%
Arkansas$42$1283454,407-6.6%
Arizona$42$1948087,211-7.3%
Minnesota$42$2394742,383-7.5%
Missouri$42$2824833,620-7.7%
New Mexico$42$144261946-7.8%
Indiana$41$2285843,943-8.8%
Massachusetts$41$2025435,915-9.0%
Kentucky$41$1824563,161-9.7%
Ohio$41$1641,2249,590-10.0%
Nebraska$41$1482151,424-10.6%
Idaho$40$1552181,133-11.1%
South Dakota$40$2001591,753-12.8%
West Virginia$39$1291791,553-13.7%
Wisconsin$39$4005123,080-14.7%
Kansas$39$2563162,816-15.0%
Rhode Island$38$16859739-16.2%
Mississippi$38$1892472,208-16.6%
Vermont$37$18328149-18.8%
North Dakota$36$18697403-20.5%
Montana$36$118141741-21.4%
Iowa$35$2342782,557-22.1%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber