90868

Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management

Medicare pricing data for 1,735 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $80 in Utah to $217 in Connecticut. 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

Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management (HCPCS code 90868) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $168.70, but hospitals typically charge $612.52 — a 3.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$33.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $168.70, your out-of-pocket cost would be approximately $33.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$168.70
Average Hospital Charge
$612.52
Markup Ratio
3.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$612.52
Medicare Allowed$168.70
Medicare Payment$133.78

Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $133.78 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$217$528142,844+28.9%
Massachusetts$216$4947912,256+28.0%
Maine$215$3854685+27.2%
Rhode Island$213$497172,012+26.2%
New Jersey$212$4534810,793+25.6%
Wisconsin$211$502202,961+24.9%
New York$210$5129516,905+24.3%
Illinois$207$6107313,042+22.8%
Minnesota$207$545504,412+22.6%
New Hampshire$199$417172,791+18.0%
Delaware$197$4985553+16.7%
Maryland$191$835356,337+13.0%
Colorado$186$1,138354,667+10.1%
Texas$181$61011515,497+7.1%
Virginia$176$743435,211+4.6%
Louisiana$174$7005789+3.0%
North Carolina$172$951566,722+2.2%
Pennsylvania$172$473626,834+2.0%
South Carolina$171$473273,058+1.2%
Georgia$169$536313,443+0.5%
Kentucky$169$466123,054+0.2%
Florida$168$46416347,612-0.3%
Alabama$167$656292,008-1.2%
Oklahoma$165$2,41351,001-2.2%
Tennessee$162$481343,258-3.8%
Mississippi$162$87661,016-4.1%
Arkansas$162$519102,328-4.2%
Ohio$161$470634,923-4.5%
West Virginia$159$371132,130-5.7%
Missouri$143$854433,315-15.5%
Kansas$138$492162,416-18.1%
Indiana$135$44413742-20.1%
Michigan$130$510343,489-22.7%
California$129$85420328,930-23.8%
New Mexico$125$7413774-25.7%
Hawaii$124$43831,424-26.4%
Iowa$124$397301,562-26.7%
Nebraska$122$550121,173-27.7%
Nevada$117$508173,356-30.7%
Washington$115$874389,130-31.8%
Arizona$112$790303,493-33.6%
Oregon$112$618283,579-33.7%
Montana$111$4846656-34.4%
South Dakota$103$58211348-38.8%
Idaho$101$46791,077-40.0%
Utah$80$688232,579-52.8%

⚠️ 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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