90937

Hemodialysis procedure requiring repeated evaluation

Medicare pricing data for 1,641 providers across 45 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

Hemodialysis procedure requiring repeated evaluation (HCPCS code 90937) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $104.33, but hospitals typically charge $402.96 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$20.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $104.33, your out-of-pocket cost would be approximately $20.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$104.33
Average Hospital Charge
$402.96
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$402.96
Medicare Allowed$104.33
Medicare Payment$82.87

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $82.87 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$137$535445+30.9%
District of Columbia$112$25311178+7.1%
New York$112$4351765,228+7.0%
New Jersey$108$341962,916+3.4%
California$107$4531364,382+2.5%
Connecticut$107$47330230+2.1%
Massachusetts$106$37336141+2.0%
Maryland$105$43451180+0.8%
Washington$104$26324116-0.6%
New Hampshire$104$1,90817295-0.7%
Colorado$102$6162068-2.4%
Illinois$102$31340324-2.4%
Texas$102$4221042,413-2.7%
Montana$101$251222-2.8%
Florida$101$2431062,683-2.8%
Michigan$101$37649550-2.8%
Pennsylvania$101$36780685-2.9%
Kentucky$100$32814194-3.9%
Hawaii$100$153339-3.9%
Virginia$100$32738379-4.0%
Delaware$100$465834-4.1%
New Mexico$100$379325-4.2%
Puerto Rico$99$11115121-4.9%
Ohio$99$35972578-5.1%
Oregon$99$352414-5.3%
Louisiana$98$26530368-5.9%
Oklahoma$98$47212162-6.1%
South Carolina$98$30823173-6.3%
Vermont$98$420333-6.4%
Missouri$98$34826549-6.5%
Georgia$97$40243208-7.0%
North Carolina$97$34175875-7.0%
Kansas$97$2881261-7.1%
Mississippi$97$313983-7.1%
West Virginia$97$218514-7.2%
Maine$96$218814-7.6%
Arkansas$96$20111206-7.7%
Iowa$96$337624-8.1%
Alabama$96$30729263-8.2%
Indiana$95$42950424-8.6%
Arizona$94$3751135-9.8%
Tennessee$93$63134520-10.6%
Wisconsin$93$8822251-10.7%
Minnesota$91$48429136-13.0%
Nebraska$83$261850-20.5%

⚠️ 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