20553

Injection of trigger points, 3 or more muscles

Medicare pricing data for 19,004 providers across 52 states

🤖AI Overview

This procedure has a 5.4x markup — hospitals charge $288.63 but Medicare allows only $53.29. Uninsured patients may face bills 5.4 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, 3 or more muscles (HCPCS code 20553) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $53.29, but hospitals typically charge $288.63 — a 5.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $53.29, your out-of-pocket cost would be approximately $10.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$53.29
Average Hospital Charge
$288.63
Markup Ratio
5.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$288.63
Medicare Allowed$53.29
Medicare Payment$40.75

Hospitals charge 5.4x more than what Medicare allows for this procedure. Medicare actually pays $40.75 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$70$49855677+31.9%
New York$64$4001,40939,273+20.5%
New Jersey$62$73859911,144+16.5%
District of Columbia$60$21939443+12.9%
Hawaii$59$14528262+10.4%
California$58$3781,84952,590+8.6%
Connecticut$56$3072224,698+5.6%
Wyoming$56$23335934+5.3%
Florida$55$2911,47530,378+3.8%
Nevada$55$2812266,859+3.3%
Maryland$54$2153637,485+0.9%
Delaware$54$23466828+0.6%
Illinois$53$28159211,135-0.3%
Pennsylvania$53$18687011,996-0.7%
Washington$52$1873845,742-1.5%
Virginia$52$2204658,768-2.1%
Oregon$52$1972233,046-2.1%
Georgia$52$2915634,601-3.2%
Rhode Island$51$24337634-4.0%
Texas$51$2631,20116,016-4.2%
Alabama$51$1632252,084-4.3%
Utah$51$2022783,806-4.4%
Arkansas$51$1421731,715-4.8%
Colorado$50$2124317,277-5.5%
Puerto Rico$50$8938297-6.2%
Massachusetts$50$21748910,183-6.7%
Kentucky$49$1742814,665-7.9%
Arizona$49$21868927,809-8.0%
North Carolina$49$27175011,061-8.6%
Indiana$49$1662742,875-8.8%
Tennessee$48$1644064,539-9.7%
New Hampshire$48$2101252,136-10.4%
Missouri$47$2352964,860-11.0%
Louisiana$47$2252263,187-11.4%
New Mexico$47$1491851,807-11.5%
Nebraska$47$1811343,025-12.2%
Ohio$46$1846359,720-12.9%
South Carolina$46$1752634,647-12.9%
Michigan$46$1944736,506-13.0%
Kansas$45$2311892,570-16.0%
Mississippi$45$2141472,505-16.4%
South Dakota$44$208741,456-16.5%
Oklahoma$44$1632052,141-16.6%
Maine$44$138741,077-16.8%
Minnesota$44$2613515,016-17.9%
Wisconsin$44$4293584,499-18.1%
West Virginia$43$148791,681-18.4%
Montana$42$140991,036-20.6%
Idaho$41$1711331,423-22.5%
Iowa$40$2061382,420-24.6%
Vermont$38$16923160-28.8%
North Dakota$37$261481,055-30.2%

⚠️ 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