Test to measure expiratory airflow and volume initiated by patient and evaluated by provider
Medicare pricing data for 204 providers across 27 states
This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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
Test to measure expiratory airflow and volume initiated by patient and evaluated by provider (HCPCS code 94016) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $24.75, but hospitals typically charge $60.25 — a 2.4x 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 $24.75, your out-of-pocket cost would be approximately $4.95. 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 2.4x more than what Medicare allows for this procedure. Medicare actually pays $18.99 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $26 | $79 | 7 | 289 | +6.4% |
| New York | $26 | $64 | 19 | 865 | +3.5% |
| Rhode Island | $26 | $118 | 1 | 13 | +3.2% |
| California | $25 | $52 | 49 | 2,836 | +2.7% |
| Connecticut | $25 | $76 | 2 | 40 | +1.8% |
| Virginia | $25 | $54 | 4 | 184 | -0.2% |
| Washington | $25 | $60 | 3 | 125 | -1.0% |
| Michigan | $24 | $38 | 5 | 25 | -2.5% |
| Florida | $24 | $44 | 28 | 477 | -3.2% |
| Arizona | $24 | $39 | 5 | 313 | -3.4% |
| Pennsylvania | $24 | $73 | 6 | 95 | -4.4% |
| Louisiana | $24 | $67 | 7 | 69 | -4.7% |
| Texas | $24 | $99 | 12 | 378 | -4.8% |
| Wisconsin | $23 | $50 | 2 | 23 | -5.3% |
| Idaho | $23 | $50 | 2 | 59 | -5.4% |
| Utah | $23 | $54 | 4 | 32 | -5.5% |
| Georgia | $23 | $83 | 8 | 352 | -5.7% |
| Iowa | $23 | $63 | 1 | 13 | -6.3% |
| Indiana | $23 | $81 | 4 | 24 | -6.4% |
| Tennessee | $23 | $54 | 3 | 11 | -6.8% |
| Missouri | $23 | $59 | 6 | 40 | -7.2% |
| Oklahoma | $22 | $102 | 3 | 43 | -9.4% |
| North Carolina | $22 | $81 | 11 | 97 | -10.4% |
| Vermont | $22 | $22 | 1 | 16 | -12.5% |
| Alabama | $21 | $41 | 5 | 18 | -15.2% |
| Illinois | $21 | $65 | 4 | 20 | -17.0% |
| Nevada | $20 | $75 | 2 | 134 | -17.2% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber