95024

Test for allergy using allergenic extract injected into skin

Medicare pricing data for 5,053 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.4 million services annually. Even small pricing inefficiencies here affect millions of patients. 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 allergy using allergenic extract injected into skin (HCPCS code 95024) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.73, but hospitals typically charge $18.54 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.73, your out-of-pocket cost would be approximately $1.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.73
Average Hospital Charge
$18.54
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$18.54
Medicare Allowed$7.73
Medicare Payment$6.05

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $6.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$10$174989+25.2%
New York$9$1925952,269+17.2%
New Jersey$9$1813128,523+17.1%
California$9$1925097,162+14.1%
Hawaii$9$1131,062+12.2%
Connecticut$9$237710,276+11.1%
Maryland$9$209426,390+10.2%
Massachusetts$8$3219455,935+8.3%
Washington$8$189416,638+7.0%
Rhode Island$8$13163,385+6.0%
Alaska$8$3613611+5.8%
Illinois$8$2018727,338+5.6%
New Hampshire$8$19131,709+4.8%
Puerto Rico$8$92909+4.1%
Colorado$8$187912,747+3.0%
Virginia$8$1417562,857+2.1%
Florida$8$18480241,820+1.8%
Delaware$8$213220,165+1.4%
Nevada$8$16214,775+1.0%
Wyoming$8$2393,122+0.5%
Pennsylvania$8$1520047,433-0.3%
Oregon$8$25619,199-0.5%
Michigan$8$1713928,877-1.6%
Texas$8$17493156,858-1.6%
Arizona$8$179325,802-1.8%
South Dakota$7$24243,986-4.7%
Vermont$7$162517-5.2%
Montana$7$20141,368-6.0%
Georgia$7$2321740,404-6.2%
North Carolina$7$1823742,698-6.5%
Utah$7$16462,813-6.9%
Missouri$7$1810121,033-7.2%
South Carolina$7$1612443,976-7.4%
New Mexico$7$20195,090-8.3%
Indiana$7$1711729,925-8.5%
Nebraska$7$20271,550-8.7%
Louisiana$7$217215,725-8.9%
Kentucky$7$1711344,487-9.3%
Oklahoma$7$163512,869-9.7%
North Dakota$7$256779-9.8%
Wisconsin$7$255410,845-9.8%
West Virginia$7$18349,545-10.3%
Alabama$7$156313,327-10.6%
Kansas$7$143611,007-11.4%
Idaho$7$17313,936-11.9%
Iowa$7$174313,286-12.3%
Maine$7$54163,351-12.3%
Tennessee$7$1819346,146-12.3%
Arkansas$7$174611,395-12.7%
Ohio$7$1615626,206-13.2%
Minnesota$7$26462,507-14.6%
Mississippi$6$15279,582-19.9%

⚠️ 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