64454

Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance

Medicare pricing data for 8,134 providers across 51 states

🤖AI Overview

This procedure has a 8.2x markup — hospitals charge $1,223 but Medicare allows only $149.88. Uninsured patients may face bills 8.2 times higher than what insurance negotiates. Prices vary significantly by location — from $83 in Hawaii to $259 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 agent and/or steroid into knee nerve branch using imaging guidance (HCPCS code 64454) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $149.88, but hospitals typically charge $1,223 — a 8.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $149.88, your out-of-pocket cost would be approximately $29.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$149.88
Average Hospital Charge
$1,223
Markup Ratio
8.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,222.81
Medicare Allowed$149.88
Medicare Payment$115.99

Hospitals charge 8.2x more than what Medicare allows for this procedure. Medicare actually pays $115.99 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$259$3,109840+73.0%
Washington$182$684122525+21.2%
North Carolina$180$8352521,500+20.2%
Virginia$180$8421651,032+19.8%
New Jersey$173$4,0002631,586+15.3%
Utah$171$67499464+14.1%
Florida$170$9956644,763+13.6%
South Carolina$170$751124792+13.3%
Connecticut$166$1,27285351+10.8%
Colorado$165$1,524131693+9.8%
Oregon$164$77899584+9.5%
Arizona$164$1,0622171,511+9.3%
Nevada$163$2,22573322+9.0%
Illinois$160$1,0203102,143+6.5%
Maryland$158$8762141,998+5.1%
New York$157$2,2144634,138+4.9%
Kentucky$157$786119933+4.8%
California$155$1,7007173,954+3.4%
Delaware$154$9281891+2.7%
Michigan$153$811218799+1.9%
Iowa$151$72955335+0.8%
Oklahoma$150$469104933+0.3%
Massachusetts$146$840166962-2.6%
New Mexico$146$79439187-2.6%
Wisconsin$144$1,7611771,183-3.7%
Vermont$144$998522-4.0%
Alabama$142$60977288-5.1%
Texas$142$1,3088565,204-5.5%
Tennessee$138$8001351,070-7.8%
Wyoming$137$7941362-8.4%
Georgia$136$1,1923502,128-9.3%
Nebraska$135$79356320-10.0%
Kansas$134$1,04877419-10.3%
Montana$134$6142194-10.5%
Minnesota$132$891139866-12.1%
District of Columbia$130$7091996-13.1%
Rhode Island$130$65224275-13.6%
Missouri$129$852129969-13.8%
Louisiana$129$1,150126632-14.1%
Arkansas$127$59395801-15.0%
Ohio$125$5922971,805-16.3%
New Hampshire$125$89950318-16.4%
Pennsylvania$125$7602881,330-16.6%
South Dakota$121$37528111-19.2%
Indiana$120$1,1711941,220-19.8%
Maine$117$31926141-22.0%
Mississippi$107$8371231,320-28.8%
Idaho$102$58445331-31.9%
West Virginia$98$74232186-34.5%
North Dakota$93$617840-38.0%
Hawaii$83$912560-44.4%

⚠️ 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