94200

Test to measure largest amount of air breathed in an out

Medicare pricing data for 1,271 providers across 36 states

🤖AI Overview

Prices vary significantly by location — from $3 in Oklahoma to $18 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 largest amount of air breathed in an out (HCPCS code 94200) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.39, but hospitals typically charge $52.84 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.88

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.39, your out-of-pocket cost would be approximately $2.88. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$14.39
Average Hospital Charge
$52.84
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$52.84
Medicare Allowed$14.39
Medicare Payment$11.14

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $11.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$18$84977,070+23.7%
District of Columbia$16$557176+12.0%
California$15$4715515,322+7.6%
Maryland$15$57141,377+5.2%
Nevada$15$58524+2.1%
Puerto Rico$14$31211,809+0.1%
Washington$14$471234-0.3%
New Jersey$14$52422,109-1.2%
Michigan$14$5530263-3.3%
Rhode Island$14$42412-3.6%
Florida$14$401515,908-5.3%
Iowa$14$71159-5.5%
North Carolina$13$5331920-6.4%
New Mexico$13$1356156-6.9%
Texas$13$5841830-6.9%
Colorado$13$3341524-8.0%
Kentucky$13$584165-8.2%
Arizona$13$49881,081-9.7%
Tennessee$13$6034522-10.7%
Missouri$13$49231,415-11.6%
Georgia$13$63421,069-12.4%
Alabama$13$52744,609-12.6%
Mississippi$12$49331,832-14.2%
Ohio$12$5119136-15.4%
Louisiana$12$51427-16.7%
Connecticut$11$5323149-23.3%
Indiana$9$4035372-35.0%
Illinois$9$4626375-35.4%
South Carolina$9$65716-36.0%
Pennsylvania$6$4056275-55.5%
Massachusetts$6$4516471-59.6%
Wisconsin$5$9911138-63.8%
Virginia$3$191850-80.1%
West Virginia$3$29424-81.5%
Hawaii$3$11386-81.8%
Oklahoma$3$191068-82.1%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber