66030

Injection of medication into eye

Medicare pricing data for 1,033 providers across 43 states

🤖AI Overview

Prices vary significantly by location — from $150 in Kansas to $678 in Hawaii. 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 medication into eye (HCPCS code 66030) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $181.06, but hospitals typically charge $449.93 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$36.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $181.06, your out-of-pocket cost would be approximately $36.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$181.06
Average Hospital Charge
$449.93
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$449.93
Medicare Allowed$181.06
Medicare Payment$139.78

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $139.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$678$1,3284129+274.2%
Arkansas$572$7831791+216.0%
Alaska$231$1,044317+27.5%
Connecticut$223$49615145+23.0%
Nevada$210$656627+16.2%
District of Columbia$208$1,339659+14.8%
Maryland$206$66428207+13.8%
New York$201$55089414+11.0%
Massachusetts$199$46451539+10.1%
New Jersey$199$44842231+10.1%
California$199$41595860+9.9%
Minnesota$199$593543+9.8%
North Dakota$196$468732+8.4%
Rhode Island$184$431332+1.8%
Illinois$184$40135218+1.5%
Oregon$182$4621061+0.4%
New Hampshire$179$484323-1.0%
Virginia$176$40638374-2.5%
Wisconsin$176$9811347-2.6%
Texas$176$51083491-2.9%
Pennsylvania$175$48048563-3.2%
Colorado$174$3521695-4.1%
Michigan$173$37420105-4.3%
Georgia$173$54231305-4.4%
Arizona$173$35116114-4.5%
Florida$172$3401081,233-4.8%
South Dakota$169$614566-6.7%
North Carolina$169$45022139-6.8%
Missouri$168$5391778-7.2%
Nebraska$167$457847-7.9%
Montana$166$566217-8.4%
New Mexico$165$277540-9.1%
Indiana$164$42129131-9.3%
Ohio$164$4061980-9.4%
Tennessee$164$35123235-9.7%
Maine$163$283839-9.8%
Oklahoma$163$4321375-9.9%
Louisiana$160$3751558-11.9%
Kentucky$159$5621142-12.0%
Alabama$158$33221155-12.7%
Mississippi$157$5331070-13.1%
South Carolina$152$39620223-15.9%
Kansas$150$555735-17.2%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber