64417

Injection of anesthetic agent and/or steroid into upper arm and shoulder nerve (axillary nerve)

Medicare pricing data for 5,069 providers across 48 states

🤖AI Overview

This procedure has a 11.3x markup — hospitals charge $963.04 but Medicare allows only $85.39. Uninsured patients may face bills 11.3 times higher than what insurance negotiates. Prices vary significantly by location — from $37 in Hawaii to $167 in Arkansas. 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 agent and/or steroid into upper arm and shoulder nerve (axillary nerve) (HCPCS code 64417) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $85.39, but hospitals typically charge $963.04 — a 11.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $85.39, your out-of-pocket cost would be approximately $17.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$85.39
Average Hospital Charge
$963.04
Markup Ratio
11.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$963.04
Medicare Allowed$85.39
Medicare Payment$66.96

Hospitals charge 11.3x more than what Medicare allows for this procedure. Medicare actually pays $66.96 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Arkansas$167$68974369+95.8%
Maryland$140$50453347+63.8%
North Carolina$130$828125496+52.1%
Pennsylvania$128$558215994+49.5%
Mississippi$113$76492492+32.8%
Minnesota$112$84870193+30.9%
New York$110$1,204179468+29.1%
Connecticut$94$1,0243892+10.4%
Wisconsin$92$1,336108291+8.0%
Illinois$92$1,081194422+7.4%
Colorado$91$1,06168191+6.1%
California$88$1,1914181,205+3.2%
Tennessee$85$853108324-0.2%
Indiana$85$1,149118253-0.7%
Florida$83$1,0123431,146-3.2%
Delaware$79$1,2542757-7.0%
Idaho$77$8353158-9.5%
New Jersey$77$1,30282177-9.9%
Nebraska$76$34170219-11.0%
Georgia$76$1,215189514-11.6%
Arizona$75$1,308147432-12.3%
Texas$75$1,1233841,007-12.4%
Nevada$72$1,03648121-16.2%
Michigan$70$1,723195709-18.3%
Kentucky$69$1,361110410-19.2%
South Dakota$69$4811438-19.5%
Wyoming$68$1,13328100-20.1%
Virginia$68$1,12481231-20.8%
Ohio$65$665223517-23.6%
Oklahoma$65$800160437-24.1%
Alabama$65$88371271-24.3%
Massachusetts$65$62463148-24.3%
Louisiana$63$74777515-26.2%
Maine$62$6752573-27.2%
Washington$62$628162483-27.2%
North Dakota$62$9381353-27.5%
Montana$62$4922745-27.9%
New Hampshire$62$6452750-27.9%
Utah$61$52558145-28.3%
Oregon$61$87380180-28.6%
West Virginia$61$1,3321943-28.6%
New Mexico$61$1,4143352-29.0%
Missouri$59$92392196-30.3%
Iowa$58$8314086-31.8%
Kansas$58$83888187-32.5%
District of Columbia$57$1,1061025-32.9%
South Carolina$49$728112604-42.3%
Hawaii$37$966966-56.3%

⚠️ 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