90945

Dialysis procedure including 1 evaluation

Medicare pricing data for 6,086 providers across 50 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

Dialysis procedure including 1 evaluation (HCPCS code 90945) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $84.26, but hospitals typically charge $292.81 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$16.85

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $84.26, your out-of-pocket cost would be approximately $16.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$84.26
Average Hospital Charge
$292.81
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$292.81
Medicare Allowed$84.26
Medicare Payment$66.88

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $66.88 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$112$7127810+33.1%
Montana$98$51414220+16.4%
California$92$3014768,638+9.4%
Massachusetts$90$3161844,204+7.4%
District of Columbia$90$31448937+7.3%
New Jersey$89$2811882,873+6.1%
New York$89$2813245,258+5.1%
Maryland$88$3072005,547+5.0%
Connecticut$88$34072963+4.2%
Illinois$87$3642263,647+3.5%
Oregon$87$23448873+3.2%
Hawaii$87$18315375+3.1%
Washington$86$2361201,435+1.6%
Colorado$86$3591061,312+1.5%
Nevada$85$26520315+1.0%
New Hampshire$85$46228868+0.7%
Virginia$85$2461553,043+0.5%
Florida$84$2593085,663+0.2%
Delaware$84$32239895+0.1%
Michigan$84$2142123,303-0.2%
Pennsylvania$84$2213625,931-0.5%
Texas$83$2684606,397-1.4%
South Dakota$83$27215174-1.9%
Maine$83$21929302-2.1%
Vermont$82$320841-2.4%
Utah$82$27736482-2.4%
Missouri$82$2811603,329-2.7%
New Mexico$82$20140494-2.8%
West Virginia$82$21330568-2.8%
Minnesota$82$3741061,210-2.8%
Louisiana$81$19287828-3.9%
North Dakota$81$31323699-4.0%
Ohio$81$3283056,886-4.3%
North Carolina$80$2742605,413-4.8%
South Carolina$80$3681262,043-5.0%
Oklahoma$80$255631,605-5.0%
Rhode Island$80$22021265-5.2%
Alabama$80$2551133,663-5.4%
Iowa$80$38353843-5.6%
Kentucky$79$24848490-5.9%
Indiana$79$2401774,056-6.0%
Nebraska$79$22732722-6.0%
Wisconsin$79$5931342,032-6.1%
Arizona$79$251851,291-6.3%
Georgia$79$3081783,229-6.4%
Kansas$79$22231532-6.4%
Arkansas$78$18344936-7.0%
Tennessee$78$3201412,546-7.4%
Mississippi$78$290561,334-7.6%
Idaho$77$17317232-8.6%

⚠️ 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