64479

Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level

Medicare pricing data for 4,292 providers across 50 states

🤖AI Overview

This procedure has a 7.0x markup — hospitals charge $1,809 but Medicare allows only $259.02. Uninsured patients may face bills 7.0 times higher than what insurance negotiates. Prices vary significantly by location — from $118 in West Virginia to $342 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 and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level (HCPCS code 64479) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $259.02, but hospitals typically charge $1,809 — a 7.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$51.80

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $259.02, your out-of-pocket cost would be approximately $51.80. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$259.02
Average Hospital Charge
$1,809
Markup Ratio
7.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,808.69
Medicare Allowed$259.02
Medicare Payment$202.24

Hospitals charge 7.0x more than what Medicare allows for this procedure. Medicare actually pays $202.24 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$342$2,50517115+32.1%
Nevada$300$3,298941,858+15.8%
California$299$3,2794215,134+15.6%
New Jersey$291$3,642125934+12.3%
Oregon$291$1,316811,138+12.2%
Florida$288$1,5902722,438+11.2%
New York$287$1,7781641,313+10.9%
Connecticut$285$1,15325142+9.8%
Virginia$282$1,60060811+9.0%
Delaware$282$1,31422622+8.9%
Rhode Island$281$1,663448+8.4%
South Carolina$272$1,17950500+4.9%
Pennsylvania$269$1,2021671,455+3.9%
Arizona$268$1,451133962+3.6%
Maryland$268$1,4451321,752+3.6%
District of Columbia$267$883322+2.9%
Puerto Rico$263$268717+1.7%
Georgia$262$1,845176832+1.2%
Massachusetts$259$1,64767740-0.1%
Washington$257$9841141,296-0.7%
Minnesota$255$1,397133758-1.5%
Illinois$252$1,77096688-2.7%
Colorado$251$2,4561361,267-3.1%
Idaho$247$1,02036155-4.7%
New Hampshire$245$1,40715213-5.2%
North Carolina$245$9481341,924-5.5%
Tennessee$242$1,408102894-6.7%
Mississippi$242$1,43948708-6.8%
Montana$242$86924216-6.8%
New Mexico$236$1,1031840-9.0%
Arkansas$234$1,43935418-9.8%
Indiana$233$1,7561251,243-10.1%
Michigan$232$1,048108414-10.5%
Ohio$230$1,1691161,700-11.1%
Kentucky$229$9473492-11.4%
Utah$227$94070382-12.5%
Texas$226$1,7523632,652-12.6%
Oklahoma$226$69933152-12.8%
Missouri$224$1,11677808-13.3%
Wyoming$214$1,15524174-17.2%
Alabama$212$1,005791,005-18.2%
Louisiana$212$1,6051021,667-18.2%
Nebraska$209$1,17334255-19.3%
Kansas$204$1,00435351-21.1%
Wisconsin$199$2,12788575-23.2%
Iowa$198$1,3691873-23.6%
North Dakota$168$6891873-35.2%
Vermont$166$1,265320-36.0%
South Dakota$157$3951372-39.5%
West Virginia$118$4691157-54.5%

⚠️ 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