90480

Admn sarscov2 vacc 1 dose

Medicare pricing data for 74,015 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 7.0 million services annually. Even small pricing inefficiencies here affect millions of patients. 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

Admn sarscov2 vacc 1 dose (HCPCS code 90480) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $37.15, but hospitals typically charge $48.68 — a 1.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $37.15, your out-of-pocket cost would be approximately $7.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$37.15
Average Hospital Charge
$48.68
Markup Ratio
1.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$48.68
Medicare Allowed$37.15
Medicare Payment$37.15

Hospitals charge 1.3x more than what Medicare allows for this procedure. Medicare actually pays $37.15 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$44$5230111,085+19.7%
Idaho$42$100367484,153+12.7%
California$41$515,891589,685+11.7%
New York$41$533,344354,672+11.4%
Hawaii$41$4523530,730+10.9%
New Jersey$41$471,922197,514+10.6%
Massachusetts$41$472,034265,488+9.6%
Maryland$41$481,794174,538+9.3%
Connecticut$40$471,27688,743+8.0%
Rhode Island$40$4331123,703+7.8%
North Dakota$39$5327420,447+5.2%
Washington$38$492,080149,359+2.9%
Florida$38$453,697409,424+2.2%
Vermont$38$4219822,639+1.9%
Delaware$38$4322136,600+1.9%
New Hampshire$37$4237262,842+0.2%
Virginia$37$452,099219,908+0.1%
Puerto Rico$37$391302,398-0.5%
Pennsylvania$37$484,258341,395-1.5%
Illinois$36$432,629258,845-2.5%
Michigan$36$442,244165,968-2.6%
Minnesota$36$443,267143,735-3.5%
Colorado$36$381,699399,159-3.9%
Oregon$36$461,28365,356-4.1%
Iowa$36$421,212136,406-4.3%
Ohio$35$452,608240,914-5.2%
Georgia$35$411,979119,402-5.3%
Montana$35$4422226,802-5.3%
Maine$35$4636923,393-5.7%
Arizona$35$391,211109,193-5.8%
Texas$35$414,061298,027-6.5%
Nevada$35$3839442,807-6.7%
North Carolina$34$473,062191,292-7.3%
Wisconsin$34$472,187164,998-8.4%
Nebraska$34$4657060,206-8.5%
South Carolina$34$411,332119,576-8.7%
Indiana$34$381,950135,447-8.9%
Tennessee$33$411,793110,114-10.0%
Missouri$33$411,262125,176-10.8%
Kentucky$33$431,39071,190-11.3%
South Dakota$33$4224830,939-11.9%
Alabama$33$3982337,482-12.0%
New Mexico$33$4534440,411-12.5%
West Virginia$32$4236421,037-12.7%
Louisiana$32$3868834,520-13.7%
Wyoming$32$3616714,098-14.2%
Utah$32$3691644,303-14.8%
Kansas$32$3980895,545-15.0%
Arkansas$31$5577759,547-17.6%
Mississippi$31$3336632,184-17.9%
Oklahoma$30$3574268,310-19.5%
Alaska$23$3419621,933-37.0%

⚠️ 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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