64415

Injection of anesthetic agent and/or steroid into arm nerve bundle (brachial plexus)

Medicare pricing data for 30,423 providers across 52 states

🤖AI Overview

This procedure has a 14.3x markup — hospitals charge $988.96 but Medicare allows only $69.27. Uninsured patients may face bills 14.3 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 arm nerve bundle (brachial plexus) (HCPCS code 64415) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $69.27, but hospitals typically charge $988.96 — a 14.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $69.27, your out-of-pocket cost would be approximately $13.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$69.27
Average Hospital Charge
$988.96
Markup Ratio
14.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$988.96
Medicare Allowed$69.27
Medicare Payment$54.84

Hospitals charge 14.3x more than what Medicare allows for this procedure. Medicare actually pays $54.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$91$1,27285434+31.2%
California$77$1,0642,59314,161+11.1%
New York$74$1,3811,5488,036+7.0%
Maryland$74$7675464,383+6.8%
District of Columbia$73$974125599+5.3%
New Jersey$73$1,2896633,204+5.2%
Rhode Island$72$80476361+4.5%
Florida$72$1,1631,79612,651+3.4%
Connecticut$71$1,3802942,108+2.9%
Massachusetts$71$7038175,074+2.0%
Colorado$71$1,0666074,719+1.8%
Delaware$71$1,35580759+1.8%
Illinois$70$1,1371,2566,854+1.7%
Puerto Rico$70$1,678730+0.8%
Pennsylvania$70$8901,2838,407+0.6%
Virginia$69$9227186,239+0.2%
Washington$69$6678063,813-0.3%
Michigan$69$1,1818874,951-0.5%
Tennessee$69$7527395,753-0.7%
Nevada$69$1,0582411,523-1.0%
Louisiana$68$7914203,114-1.2%
Montana$68$6511801,321-1.7%
Hawaii$68$71884440-1.7%
Ohio$68$7311,3328,606-1.9%
Minnesota$68$1,0945913,251-1.9%
Arizona$68$1,0667934,941-2.2%
New Mexico$68$1,229192868-2.2%
Texas$68$1,4472,32814,123-2.2%
Oregon$68$8754402,221-2.3%
West Virginia$68$815127679-2.4%
New Hampshire$67$9392071,113-2.9%
Wyoming$67$1,03666491-3.0%
Georgia$67$8698635,921-3.0%
North Carolina$67$1,1528528,034-3.3%
Kansas$67$8364132,837-3.6%
Maine$67$577196883-3.6%
Kentucky$67$7964672,928-3.6%
Missouri$67$8006285,028-3.8%
Utah$67$7763762,376-3.9%
North Dakota$67$44384679-3.9%
Wisconsin$66$1,4767423,445-4.1%
Indiana$66$8408665,514-4.4%
Vermont$66$78552251-4.4%
Iowa$66$9154302,538-5.1%
Mississippi$66$6212612,374-5.1%
Oklahoma$66$8234473,639-5.3%
South Dakota$66$3801151,028-5.4%
South Carolina$65$8244815,293-5.6%
Alabama$65$5723693,090-5.8%
Nebraska$65$5953161,956-6.8%
Idaho$64$6441921,373-6.9%
Arkansas$64$6872882,636-7.7%

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

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