Nursing facility ventilation assistance and management
Medicare pricing data for 68 providers across 12 states
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
Nursing facility ventilation assistance and management (HCPCS code 94004) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $48.65, but hospitals typically charge $97.90 — a 2.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $48.65, your out-of-pocket cost would be approximately $9.73. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $38.08 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $54 | $106 | 15 | 1,613 | +11.6% |
| California | $51 | $75 | 4 | 1,553 | +4.5% |
| New Jersey | $51 | $79 | 4 | 4,806 | +3.9% |
| Connecticut | $50 | $110 | 1 | 494 | +2.4% |
| Maryland | $48 | $99 | 15 | 3,614 | -1.6% |
| Delaware | $48 | $100 | 1 | 147 | -2.0% |
| Pennsylvania | $47 | $109 | 4 | 1,914 | -2.5% |
| Florida | $47 | $135 | 3 | 536 | -2.5% |
| Texas | $46 | $100 | 1 | 474 | -6.1% |
| Illinois | $44 | $175 | 4 | 759 | -8.8% |
| Tennessee | $39 | $75 | 7 | 842 | -19.7% |
| Indiana | $39 | $160 | 4 | 346 | -19.8% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber