94617

Test for exercise-induced spasm of lung airways

Medicare pricing data for 160 providers across 19 states

🤖AI Overview

Prices vary significantly by location — from $28 in Kentucky to $102 in New York. Where you get this procedure matters more than almost any other factor. 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 for exercise-induced spasm of lung airways (HCPCS code 94617) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $70.00, but hospitals typically charge $133.47 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.00

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $70.00, your out-of-pocket cost would be approximately $14.00. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$70.00
Average Hospital Charge
$133.47
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$133.47
Medicare Allowed$70.00
Medicare Payment$54.38

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $54.38 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$102$1986969+45.2%
Maryland$99$192619+41.2%
Massachusetts$95$1532114+35.8%
California$93$26915553+32.8%
Rhode Island$89$211371+27.3%
Illinois$89$110769+26.5%
South Carolina$81$142243+15.5%
North Carolina$81$1448446+15.1%
Ohio$76$183615+7.9%
Alabama$74$13211194+6.0%
Indiana$74$75118+5.5%
Virginia$70$1224130+0.6%
Texas$63$10020111-10.0%
Florida$53$85283,077-24.0%
Connecticut$33$117561-53.1%
Pennsylvania$32$126612-54.5%
West Virginia$30$175117-57.0%
Mississippi$30$200769-57.1%
Kentucky$28$55614-59.3%

⚠️ 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