94668

Follow-up therapy service to facilitate lung function

Medicare pricing data for 41 providers across 6 states

🤖AI Overview

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

Follow-up therapy service to facilitate lung function (HCPCS code 94668) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $32.54, but hospitals typically charge $35.54 — a 1.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $32.54, your out-of-pocket cost would be approximately $6.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$32.54
Average Hospital Charge
$35.54
Markup Ratio
1.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$35.54
Medicare Allowed$32.54
Medicare Payment$25.68

Hospitals charge 1.1x more than what Medicare allows for this procedure. Medicare actually pays $25.68 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$45$6411423+37.5%
Oklahoma$43$501638+31.4%
Florida$35$57546+8.2%
Virginia$35$56621+8.2%
California$30$31104,588-7.5%
Puerto Rico$25$26287-22.6%

⚠️ 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