64646

Injection of chemical for paralysis of nerve muscles on trunk, 1-5 muscles

Medicare pricing data for 947 providers across 45 states

🤖AI Overview

Prices vary significantly by location — from $55 in Mississippi to $145 in Connecticut. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 trunk, 1-5 muscles (HCPCS code 64646) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $110.48, but hospitals typically charge $436.18 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$22.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $110.48, your out-of-pocket cost would be approximately $22.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$110.48
Average Hospital Charge
$436.18
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$436.18
Medicare Allowed$110.48
Medicare Payment$85.51

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $85.51 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$145$61616104+31.4%
Wyoming$145$521220+31.3%
Kansas$135$7081036+22.0%
New York$134$80270312+21.5%
Washington$132$4212341+19.1%
Massachusetts$131$5612462+18.2%
Arizona$129$25425992+17.1%
Pennsylvania$128$40560346+15.8%
Michigan$124$5582156+12.6%
Tennessee$124$4921845+11.8%
New Mexico$121$338316+9.5%
Maryland$121$3261494+9.4%
Maine$118$376517+6.8%
Missouri$117$5381587+6.3%
Utah$117$4371038+5.9%
South Carolina$115$5021235+4.1%
Louisiana$114$491929+3.2%
Indiana$114$3641550+3.1%
Georgia$113$5001899+2.6%
North Carolina$112$49538161+1.0%
Rhode Island$111$558478+0.1%
California$110$42479519-0.2%
New Jersey$110$66421115-0.3%
Oregon$108$4832285-2.0%
Nebraska$108$426828-2.1%
District of Columbia$108$46513294-2.3%
West Virginia$106$371553-3.9%
Illinois$106$6262159-4.3%
Nevada$106$603725-4.5%
Wisconsin$104$1,0302694-5.5%
Minnesota$104$64037169-5.8%
Texas$104$50664446-5.8%
Florida$101$41980939-8.7%
Montana$95$352631-14.5%
Virginia$94$32519158-14.6%
Delaware$93$328446-16.1%
Colorado$92$34832291-17.1%
Iowa$90$30116142-18.7%
Ohio$89$37635307-19.3%
Oklahoma$86$312987-22.3%
Kentucky$85$376546-23.0%
Idaho$81$317652-26.4%
Arkansas$80$4111031-27.5%
Alabama$76$22811245-31.0%
Mississippi$55$412393-49.9%

⚠️ 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

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