27096

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

Medicare pricing data for 14,487 providers across 52 states

🤖AI Overview

This procedure has a 6.4x markup — hospitals charge $941.20 but Medicare allows only $147.27. Uninsured patients may face bills 6.4 times higher than what insurance negotiates. Prices vary significantly by location — from $104 in North Dakota to $211 in Alaska. 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

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance (HCPCS code 27096) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $147.27, but hospitals typically charge $941.20 — a 6.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.45

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $147.27, your out-of-pocket cost would be approximately $29.45. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$147.27
Average Hospital Charge
$941.20
Markup Ratio
6.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$941.20
Medicare Allowed$147.27
Medicare Payment$112.41

Hospitals charge 6.4x more than what Medicare allows for this procedure. Medicare actually pays $112.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$211$1,89240608+43.0%
Virginia$184$1,1293279,741+25.3%
New York$173$89376811,627+17.3%
New Jersey$171$2,2004396,533+15.9%
Florida$170$8891,32532,830+15.4%
Utah$167$6241873,950+13.4%
District of Columbia$164$94829334+11.7%
Michigan$164$7894769,690+11.1%
South Carolina$163$9402197,795+10.5%
North Carolina$162$1,11848112,770+10.0%
Nevada$161$1,4761261,932+9.1%
Connecticut$160$1,0301642,510+8.4%
Arizona$159$71935410,280+8.3%
Hawaii$159$46520160+7.7%
Illinois$158$1,10251111,411+7.0%
Nebraska$158$8851142,735+7.0%
Kentucky$150$7742076,521+1.7%
Maine$148$587371,092+0.7%
California$148$9751,15521,627+0.2%
Puerto Rico$146$19521119-1.0%
Wyoming$146$66835429-1.0%
New Mexico$145$774821,123-1.7%
Delaware$144$1,620501,143-2.2%
Rhode Island$144$97844734-2.5%
Oklahoma$144$6751814,437-2.6%
Texas$142$1,0331,21620,474-3.4%
Massachusetts$140$1,1023426,935-4.8%
Washington$140$6783024,690-5.0%
Oregon$139$6961672,955-5.3%
Tennessee$139$7482574,976-5.5%
New Hampshire$138$962941,474-6.1%
Colorado$138$8022814,701-6.4%
Iowa$137$1,1551203,120-7.2%
Maryland$137$6512835,154-7.3%
Arkansas$133$7131603,553-9.5%
Pennsylvania$133$85361312,277-9.5%
Alabama$131$6181865,217-11.4%
Indiana$130$1,0453046,490-11.9%
Ohio$125$64154511,723-15.3%
Missouri$124$9102937,258-15.8%
Minnesota$123$8793544,613-16.2%
Georgia$121$1,00946210,297-17.8%
Wisconsin$120$1,7022835,129-18.5%
Vermont$119$86520465-19.5%
Louisiana$117$1,0862263,528-20.8%
Montana$116$53253979-21.3%
West Virginia$108$360591,535-26.7%
Kansas$107$6991613,360-27.0%
Mississippi$107$1,0811053,210-27.5%
Idaho$106$5701102,033-27.8%
South Dakota$106$409531,819-28.0%
North Dakota$104$739411,499-29.5%

⚠️ 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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