94060

Test to measure expiratory airflow and volume changes before and after medication administration

Medicare pricing data for 22,787 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $11 in Idaho to $39 in New York. Where you get this procedure matters more than almost any other factor. 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 changes before and after medication administration (HCPCS code 94060) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $28.10, but hospitals typically charge $122.53 — a 4.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$5.62

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $28.10, your out-of-pocket cost would be approximately $5.62. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$28.10
Average Hospital Charge
$122.53
Markup Ratio
4.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$122.53
Medicare Allowed$28.10
Medicare Payment$21.32

Hospitals charge 4.4x more than what Medicare allows for this procedure. Medicare actually pays $21.32 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$39$1791,59777,659+38.8%
Puerto Rico$38$49731,431+33.8%
New Jersey$36$14082035,107+29.2%
Maryland$35$14341817,984+25.4%
California$34$1281,56669,351+21.0%
Arizona$32$10265827,868+14.4%
District of Columbia$32$116571,495+13.7%
Connecticut$32$15830210,262+13.4%
Florida$32$1101,70376,451+12.9%
Texas$32$1291,77456,812+12.2%
Nevada$31$1271947,789+10.6%
Georgia$31$15875923,232+9.8%
Virginia$29$11355224,099+3.7%
Alabama$28$10434110,587+0.6%
Delaware$28$115514,806-0.6%
South Carolina$28$13239212,478-0.6%
North Carolina$27$13572418,494-2.2%
Tennessee$26$10676312,303-7.5%
Michigan$26$9498825,949-7.7%
Washington$26$11243913,435-8.4%
New Mexico$26$1051073,616-8.6%
Kansas$25$1382097,330-10.3%
Alaska$24$19654899-13.1%
Colorado$24$824649,060-15.9%
Minnesota$24$1593528,910-16.3%
Nebraska$23$731756,931-18.8%
Utah$22$931623,903-22.1%
West Virginia$22$1221585,689-22.4%
Rhode Island$21$121712,250-23.7%
Illinois$21$13273427,346-24.9%
Arkansas$21$951786,952-25.8%
Pennsylvania$21$9498233,561-25.9%
Mississippi$21$1151655,227-26.0%
Oregon$20$1082657,549-27.8%
Massachusetts$20$10148622,728-28.1%
Indiana$20$9554019,904-28.4%
Kentucky$20$7938110,463-29.9%
Louisiana$20$1202306,592-29.9%
Wyoming$20$18439457-30.2%
Maine$18$116961,921-35.6%
Oklahoma$18$732517,168-35.6%
Missouri$17$9445113,945-38.3%
Ohio$17$891,02227,416-39.1%
Montana$17$62712,774-40.0%
Iowa$16$961937,228-41.5%
Wisconsin$16$2263419,695-41.5%
New Hampshire$13$1361144,239-54.3%
South Dakota$12$46723,146-57.0%
Hawaii$12$4248662-58.0%
North Dakota$12$76591,867-58.2%
Vermont$12$128341,158-58.8%
Idaho$11$611083,542-59.1%

⚠️ 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