Test to measure exhaled air for evaluation of lung function at rest
Medicare pricing data for 518 providers across 28 states
Prices vary significantly by location — from $3 in Wisconsin to $57 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 to measure exhaled air for evaluation of lung function at rest (HCPCS code 94690) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $45.54, but hospitals typically charge $140.23 — a 3.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $45.54, your out-of-pocket cost would be approximately $9.11. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $34.31 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $57 | $162 | 69 | 1,260 | +25.0% |
| California | $55 | $195 | 11 | 972 | +21.6% |
| New Jersey | $54 | $223 | 12 | 87 | +19.0% |
| Massachusetts | $53 | $173 | 7 | 40 | +15.4% |
| Maryland | $51 | $131 | 30 | 260 | +11.2% |
| Pennsylvania | $50 | $126 | 10 | 107 | +8.9% |
| Illinois | $49 | $139 | 11 | 69 | +6.9% |
| Michigan | $47 | $94 | 12 | 273 | +2.6% |
| Virginia | $44 | $115 | 15 | 167 | -2.3% |
| Florida | $44 | $125 | 52 | 1,840 | -2.6% |
| Minnesota | $43 | $168 | 20 | 143 | -5.3% |
| Texas | $43 | $111 | 21 | 184 | -5.7% |
| North Carolina | $42 | $143 | 57 | 985 | -7.4% |
| Arizona | $42 | $163 | 69 | 1,217 | -8.6% |
| Ohio | $41 | $104 | 7 | 25 | -9.0% |
| Georgia | $41 | $145 | 13 | 167 | -9.4% |
| Alabama | $41 | $110 | 12 | 382 | -10.7% |
| Utah | $40 | $160 | 9 | 98 | -11.4% |
| South Carolina | $39 | $209 | 9 | 129 | -13.4% |
| Mississippi | $39 | $95 | 22 | 1,233 | -13.9% |
| Nevada | $38 | $98 | 1 | 45 | -16.0% |
| Iowa | $37 | $253 | 6 | 26 | -18.9% |
| Oklahoma | $37 | $40 | 5 | 28 | -19.5% |
| Louisiana | $36 | $76 | 1 | 34 | -21.7% |
| Tennessee | $19 | $78 | 11 | 77 | -57.2% |
| Kentucky | $18 | $55 | 2 | 16 | -60.8% |
| South Dakota | $3 | $19 | 2 | 28 | -92.4% |
| Wisconsin | $3 | $155 | 2 | 27 | -92.5% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber