92540

Evaluation and testing for balance with recording

Medicare pricing data for 3,810 providers across 51 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

Evaluation and testing for balance with recording (HCPCS code 92540) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $106.58, but hospitals typically charge $286.27 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.32

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $106.58, your out-of-pocket cost would be approximately $21.32. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$106.58
Average Hospital Charge
$286.27
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$286.27
Medicare Allowed$106.58
Medicare Payment$82.19

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $82.19 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$118$4072047,051+10.9%
Connecticut$115$29256591+8.3%
New Jersey$115$2421332,679+8.2%
Maryland$115$2401183,816+7.9%
Hawaii$113$1877188+6.2%
New York$113$25835214,373+5.9%
Colorado$111$27365710+4.0%
Delaware$109$21614308+2.5%
Wyoming$108$329442+1.7%
Rhode Island$108$268630+1.7%
Nevada$108$335311,370+1.4%
Virginia$107$2371021,395+0.8%
Florida$107$2904068,387+0.6%
Illinois$107$4561111,470+0.6%
Puerto Rico$104$12731154-2.2%
Montana$104$22114217-2.3%
Washington$104$26060868-2.6%
Texas$104$2932754,004-2.8%
Utah$103$28550619-3.1%
Michigan$102$2661601,676-4.2%
District of Columbia$102$201977-4.4%
Pennsylvania$102$3141221,466-4.5%
Georgia$102$3181531,716-4.7%
North Carolina$101$2641161,508-4.9%
Oklahoma$101$24937715-5.0%
Indiana$101$225691,172-5.0%
Iowa$101$29626213-5.1%
Kentucky$101$20248499-5.6%
South Carolina$101$34674846-5.6%
Nebraska$100$22329402-5.7%
West Virginia$100$19217393-5.8%
Minnesota$99$50232454-7.2%
Tennessee$99$312971,222-7.4%
Alabama$98$2391011,466-7.7%
Missouri$98$28545973-7.8%
New Mexico$98$22921159-7.8%
Mississippi$98$31641592-8.1%
Kansas$97$244411,173-8.7%
New Hampshire$97$23720212-8.7%
Louisiana$96$273811,330-10.1%
Massachusetts$95$32257989-10.5%
Maine$94$156665-11.7%
Ohio$93$2521201,147-12.7%
Oregon$92$29724380-13.3%
Arkansas$92$25117173-14.0%
North Dakota$90$315517-15.9%
Arizona$89$2051023,093-16.5%
Idaho$89$20225338-16.7%
Vermont$87$252735-18.3%
Wisconsin$87$65242276-18.4%
South Dakota$79$1789200-26.2%

⚠️ 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