64418

Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve

Medicare pricing data for 4,055 providers across 47 states

🤖AI Overview

This procedure has a 8.3x markup — hospitals charge $634.02 but Medicare allows only $76.03. Uninsured patients may face bills 8.3 times higher than what insurance negotiates. Prices vary significantly by location — from $28 in Hawaii to $104 in New Jersey. 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 suprascapular shoulder nerve (HCPCS code 64418) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $76.03, but hospitals typically charge $634.02 — a 8.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $76.03, your out-of-pocket cost would be approximately $15.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$76.03
Average Hospital Charge
$634.02
Markup Ratio
8.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$634.02
Medicare Allowed$76.03
Medicare Payment$58.64

Hospitals charge 8.3x more than what Medicare allows for this procedure. Medicare actually pays $58.64 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$104$2,492114851+37.4%
New York$98$7272381,926+29.4%
South Carolina$91$51846284+20.1%
Puerto Rico$89$115524+17.6%
District of Columbia$88$224436+16.1%
California$86$8553052,021+13.1%
Florida$84$4613663,862+11.0%
Virginia$84$39782367+10.5%
New Mexico$84$494722+9.9%
Connecticut$80$68432117+5.4%
Rhode Island$79$3266119+4.3%
Ohio$79$4151711,037+4.2%
Colorado$79$58356370+4.0%
Delaware$78$7321277+2.4%
Iowa$76$4391332+0.2%
Washington$76$59956149-0.0%
Illinois$74$602153612-3.2%
Arizona$73$608125573-3.5%
North Carolina$73$561123772-3.8%
Michigan$73$389122333-4.1%
Idaho$72$317819-5.8%
Alabama$72$24253181-5.9%
Louisiana$71$54955575-6.3%
Indiana$70$54377507-7.7%
Texas$69$6644511,830-8.7%
Pennsylvania$68$3721421,322-10.7%
South Dakota$67$2481565-11.3%
Kansas$67$4772785-11.4%
Missouri$66$43359197-12.8%
Georgia$65$792160559-13.9%
Kentucky$65$55968348-14.2%
Oregon$64$35554218-15.5%
Oklahoma$64$33455249-15.6%
Maryland$64$254871,061-16.1%
Massachusetts$63$427122447-16.7%
Utah$63$3964599-17.0%
Tennessee$60$56297545-20.5%
New Hampshire$59$74615102-22.2%
Nevada$58$1,76248100-23.2%
Mississippi$56$82235341-26.1%
Minnesota$55$55177347-27.2%
Wisconsin$55$99695405-28.0%
Nebraska$54$3852886-28.7%
West Virginia$45$1,1951433-41.3%
Maine$41$6711169-46.7%
Arkansas$39$39759412-48.2%
Hawaii$28$1,013457-63.3%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber