94664

Evaluation of use of breathing device

Medicare pricing data for 6,097 providers across 49 states

🤖AI Overview

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

Evaluation of use of breathing device (HCPCS code 94664) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $17.10, but hospitals typically charge $46.04 — a 2.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.42

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $17.10, your out-of-pocket cost would be approximately $3.42. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$17.10
Average Hospital Charge
$46.04
Markup Ratio
2.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$46.04
Medicare Allowed$17.10
Medicare Payment$13.04

Hospitals charge 2.7x more than what Medicare allows for this procedure. Medicare actually pays $13.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$21$38644+22.0%
New York$20$5044710,544+19.2%
California$20$5447013,405+14.4%
New Jersey$19$612133,280+13.6%
Massachusetts$19$5686675+10.6%
Alaska$19$55119+8.5%
Connecticut$19$54841,844+8.2%
Maryland$18$511182,403+4.2%
Oklahoma$18$39491,223+4.2%
Hawaii$18$55615+4.1%
Pennsylvania$18$412272,744+3.1%
New Hampshire$18$436153+2.9%
Rhode Island$17$2821206+2.3%
Colorado$17$3793956+1.9%
Washington$17$4355278+1.5%
Virginia$17$401292,635+0.2%
Delaware$17$52371,786-0.2%
Minnesota$17$75115502-1.2%
Nevada$17$44582,231-1.3%
Montana$17$441261-2.1%
Oregon$17$5361510-3.2%
Michigan$17$351641,499-3.3%
Illinois$16$521693,324-3.6%
Puerto Rico$16$2136456-4.2%
Florida$16$3859312,469-4.5%
Texas$16$444778,979-4.7%
Vermont$16$35532-4.9%
Arizona$16$512082,757-5.1%
Wisconsin$16$14250220-5.5%
Maine$16$36826-6.8%
Georgia$16$512372,981-8.4%
Ohio$16$282712,295-9.4%
North Carolina$15$452743,007-9.6%
Missouri$15$11674749-10.9%
Indiana$15$461761,671-11.1%
South Carolina$15$521341,690-12.0%
Kansas$15$4456825-12.0%
Iowa$15$4629240-13.4%
Nebraska$15$3451288-13.6%
Louisiana$15$34861,465-14.7%
Tennessee$15$391992,044-15.0%
Alabama$14$321644,309-15.3%
Kentucky$14$37102960-15.6%
Utah$14$3921334-15.8%
West Virginia$14$3216105-15.8%
Mississippi$14$41783,281-16.4%
Arkansas$14$3474763-17.8%
New Mexico$14$4331174-18.0%
Idaho$14$371117-19.2%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber