64642

Injection of chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity

Medicare pricing data for 4,162 providers across 50 states

🤖AI Overview

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 chemical for paralysis of nerve muscles on arm or leg, 1-4 muscles, first extremity (HCPCS code 64642) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $123.94, but hospitals typically charge $494.08 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$24.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $123.94, your out-of-pocket cost would be approximately $24.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$123.94
Average Hospital Charge
$494.08
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$494.08
Medicare Allowed$123.94
Medicare Payment$93.73

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $93.73 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$152$8692743,119+22.5%
Connecticut$149$525601,039+20.3%
New Jersey$140$657107741+13.1%
Hawaii$140$367848+13.1%
District of Columbia$135$41130363+8.7%
Rhode Island$134$5017164+7.9%
Illinois$133$5211811,479+7.5%
Maryland$133$36290782+7.5%
Wyoming$133$5651172+7.5%
Florida$133$4252482,390+7.3%
California$131$5443443,856+6.0%
Delaware$131$27817560+6.0%
Massachusetts$130$5211421,846+4.5%
Colorado$126$43999830+2.0%
Georgia$125$50094709+0.9%
South Carolina$125$36561709+0.8%
Oregon$124$43156378+0.2%
Texas$124$4852522,391+0.2%
Indiana$124$400102774+0.0%
Nevada$124$50025293-0.3%
Michigan$123$4021511,023-0.9%
North Carolina$122$4331401,317-1.6%
Missouri$122$414105989-1.8%
Pennsylvania$122$3642032,721-2.0%
Washington$121$3411091,049-2.1%
Arizona$121$39265734-2.3%
Louisiana$120$38056408-3.2%
Alabama$119$42537306-3.9%
Kansas$118$56434271-4.5%
Montana$117$29424269-5.9%
Virginia$116$384109936-6.3%
Tennessee$111$43779562-10.1%
New Hampshire$111$52627342-10.1%
New Mexico$111$35428124-10.2%
Minnesota$111$5711191,508-10.8%
Utah$110$41331328-11.5%
South Dakota$109$26818224-12.4%
Iowa$108$41040581-12.6%
Ohio$106$4311711,815-14.4%
Kentucky$106$34961504-14.6%
West Virginia$102$37321161-17.5%
Oklahoma$102$28928609-17.9%
Wisconsin$100$1,1001051,297-18.9%
Maine$100$32223274-19.1%
Nebraska$99$42232374-20.0%
Idaho$98$25529213-21.0%
Vermont$97$20510129-21.5%
Arkansas$95$37530337-23.4%
North Dakota$94$20721235-24.1%
Mississippi$92$45424335-25.4%

⚠️ 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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