90962

Dialysis services, 1 physician visit per month (20 years or older)

Medicare pricing data for 8,800 providers across 52 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 services, 1 physician visit per month (20 years or older) (HCPCS code 90962) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $200.07, but hospitals typically charge $490.07 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$40.01

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $200.07, your out-of-pocket cost would be approximately $40.01. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$200.07
Average Hospital Charge
$490.07
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$490.07
Medicare Allowed$200.07
Medicare Payment$157.63

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $157.63 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$251$1,0318151+25.5%
District of Columbia$219$494391,396+9.6%
New York$216$5205166,074+8.1%
California$216$55890025,620+7.7%
New Jersey$214$4652964,429+7.2%
Massachusetts$213$6121703,110+6.4%
Maryland$211$4461902,281+5.3%
Connecticut$210$55284461+5.0%
Washington$203$5101676,310+1.5%
New Hampshire$202$68221157+1.2%
Rhode Island$202$4622394+0.9%
Illinois$202$5353785,364+0.9%
Montana$200$546221,242+0.1%
Florida$199$40457810,276-0.7%
Virginia$197$4742162,094-1.4%
Michigan$197$4092893,870-1.4%
Colorado$197$479116953-1.7%
Oregon$196$5251041,892-2.2%
Puerto Rico$196$21253770-2.3%
Texas$196$4517156,174-2.3%
Maine$195$52323134-2.7%
Pennsylvania$194$4103522,699-2.8%
North Dakota$194$595301,420-3.0%
Hawaii$193$532622,284-3.4%
New Mexico$193$48655904-3.6%
Minnesota$193$6101554,355-3.6%
South Dakota$193$42532705-3.7%
Missouri$192$4411853,623-3.9%
Georgia$192$4723414,252-3.9%
Wyoming$192$5739420-4.2%
West Virginia$190$40560998-4.9%
Ohio$190$4363713,930-5.3%
Kansas$189$43341942-5.5%
Utah$189$43158737-5.6%
Louisiana$188$4051602,740-5.8%
Arizona$188$4311913,002-6.0%
Kentucky$188$3871431,747-6.1%
Oklahoma$187$389974,312-6.4%
Indiana$187$4141842,190-6.6%
Nevada$187$534100763-6.7%
Idaho$186$43037499-7.0%
Nebraska$186$52747831-7.1%
Delaware$185$45248347-7.3%
Iowa$185$49955711-7.5%
Tennessee$185$4591803,060-7.6%
Vermont$185$771649-7.7%
Wisconsin$184$8531221,113-7.9%
South Carolina$184$462153829-8.0%
Mississippi$182$543871,339-9.2%
Arkansas$182$391641,419-9.2%
North Carolina$181$5243041,445-9.7%
Alabama$178$4451391,051-11.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber