94726

Test to determine lung volumes using sensors

Medicare pricing data for 12,280 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $13 in Idaho to $49 in Puerto Rico. 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 determine lung volumes using sensors (HCPCS code 94726) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $33.72, but hospitals typically charge $111.91 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $33.72, your out-of-pocket cost would be approximately $6.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$33.72
Average Hospital Charge
$111.91
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$111.91
Medicare Allowed$33.72
Medicare Payment$25.84

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $25.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$49$6128295+45.6%
New York$49$19376241,639+45.2%
New Jersey$47$14429712,739+40.5%
District of Columbia$46$156391,474+37.8%
Maryland$45$13120710,183+34.1%
Arizona$43$10924019,079+28.4%
Florida$43$11672151,128+27.4%
Georgia$43$14941917,696+26.5%
California$41$11083750,425+22.7%
Nevada$39$122855,093+16.3%
Texas$39$11882248,664+15.5%
North Carolina$39$12146522,494+15.2%
Alabama$38$921456,912+11.6%
South Carolina$35$10524412,704+4.7%
Minnesota$35$18521310,954+4.3%
Virginia$35$10135920,526+3.6%
New Mexico$34$107573,292+0.4%
Washington$33$10931512,620-0.9%
Rhode Island$33$115432,511-1.3%
Delaware$33$123264,864-2.0%
Mississippi$33$1151248,447-2.1%
Kansas$32$1381408,813-6.3%
Tennessee$31$8627712,044-6.8%
Nebraska$31$691266,389-9.0%
Connecticut$30$1381553,841-10.4%
Illinois$28$12451031,908-17.2%
Michigan$27$6953218,624-20.0%
Kentucky$26$7526511,469-21.6%
Colorado$26$1022317,982-22.4%
Utah$26$71621,915-23.3%
Maine$25$174612,124-25.7%
Hawaii$25$5536725-26.1%
West Virginia$25$64964,116-27.0%
Alaska$24$113291,268-28.4%
Oregon$23$871575,842-32.0%
Louisiana$23$1031235,851-32.7%
Missouri$23$8032217,777-32.9%
Pennsylvania$22$7660426,722-36.2%
Oklahoma$21$591496,205-37.6%
Wisconsin$21$22523310,402-37.8%
Massachusetts$21$7429513,149-38.1%
Arkansas$21$73796,535-38.5%
Wyoming$21$7911335-38.8%
Vermont$20$67311,112-39.4%
Montana$20$69402,251-41.2%
Ohio$20$6262021,604-41.9%
Indiana$19$6329813,623-43.0%
Iowa$17$701215,977-50.1%
South Dakota$15$42462,214-55.1%
New Hampshire$15$90703,604-56.0%
North Dakota$14$64371,847-58.5%
Idaho$13$62753,991-60.1%

⚠️ 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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