64405

Injection of anesthetic agent and/or steroid into upper neck and back of head nerve

Medicare pricing data for 11,173 providers across 52 states

🤖AI Overview

This procedure has a 7.2x markup — hospitals charge $527.72 but Medicare allows only $73.31. Uninsured patients may face bills 7.2 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 anesthetic agent and/or steroid into upper neck and back of head nerve (HCPCS code 64405) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $73.31, but hospitals typically charge $527.72 — a 7.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $73.31, your out-of-pocket cost would be approximately $14.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$73.31
Average Hospital Charge
$527.72
Markup Ratio
7.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$527.72
Medicare Allowed$73.31
Medicare Payment$55.96

Hospitals charge 7.2x more than what Medicare allows for this procedure. Medicare actually pays $55.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$93$48115129+26.8%
Alaska$93$1,27124122+26.5%
Michigan$88$4214713,954+19.9%
Florida$86$3907814,395+16.7%
Wyoming$83$44834207+12.7%
Kentucky$82$430152905+12.4%
Illinois$82$6603961,902+12.3%
South Carolina$80$3921911,049+9.1%
Connecticut$79$540120634+7.1%
District of Columbia$78$39422224+6.4%
Vermont$78$33323152+6.3%
New Jersey$76$2,3272681,339+4.3%
Utah$76$456144822+3.5%
Nebraska$75$41457209+2.8%
Virginia$75$3612332,090+1.9%
California$75$5389699,351+1.8%
Alabama$74$277126928+1.2%
New Hampshire$74$61284609+1.0%
Indiana$74$5812461,085+0.8%
West Virginia$74$45446247+0.6%
Texas$74$5428164,166+0.5%
New Mexico$74$28968377+0.4%
Pennsylvania$73$4774803,659+0.2%
Rhode Island$73$31630101+0.1%
New York$71$5686195,840-2.7%
North Dakota$71$37542472-2.9%
Delaware$71$43544233-3.3%
Massachusetts$71$4663394,348-3.4%
Maryland$71$4632691,511-3.7%
Georgia$71$5982721,168-3.8%
Montana$70$27876656-4.0%
Nevada$70$871103461-4.3%
North Carolina$70$5103662,211-4.8%
Oregon$69$369136792-5.3%
Minnesota$69$7202792,309-5.9%
Colorado$69$4442451,713-5.9%
Washington$69$3512721,705-6.2%
Ohio$69$3873682,195-6.2%
Wisconsin$68$1,3052021,108-7.7%
Missouri$67$480187976-8.0%
Louisiana$67$534153668-8.5%
Oklahoma$67$301152859-8.5%
South Dakota$67$27471340-8.5%
Iowa$66$49286659-10.1%
Arkansas$66$414128750-10.2%
Maine$66$25544339-10.6%
Tennessee$65$4582361,270-11.4%
Idaho$64$35182495-12.9%
Puerto Rico$63$249568-14.0%
Arizona$63$4973613,074-14.1%
Kansas$62$491131660-15.8%
Mississippi$58$35691591-20.9%

⚠️ 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