95027

Test for allergy using airborne allergenic extract injected into skin

Medicare pricing data for 318 providers across 33 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

Test for allergy using airborne allergenic extract injected into skin (HCPCS code 95027) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.88, but hospitals typically charge $16.23 — a 3.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.98

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.88, your out-of-pocket cost would be approximately $0.98. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.88
Average Hospital Charge
$16.23
Markup Ratio
3.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$16.23
Medicare Allowed$4.88
Medicare Payment$3.80

Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $3.80 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$6$15112,279+24.8%
Virginia$6$1563,809+21.3%
New York$6$168894+16.4%
New Jersey$6$11277+16.2%
Connecticut$6$155159+13.1%
Florida$5$13317,222+10.7%
Massachusetts$5$25726,030+7.0%
Texas$5$15141,978+4.5%
New Hampshire$5$1422,883+4.1%
Wyoming$5$18161+1.0%
Arizona$5$10910,248-0.2%
Washington$5$156364-0.4%
Michigan$5$861,188-2.3%
Pennsylvania$5$14174,031-2.7%
North Carolina$5$14212,479-5.7%
Louisiana$4$1391,725-8.2%
South Carolina$4$151417,554-8.2%
Georgia$4$14123,140-8.4%
Indiana$4$196142-9.0%
Wisconsin$4$155186-9.0%
Iowa$4$1221,993-10.0%
North Dakota$4$2621,260-10.7%
Oklahoma$4$1113240-11.7%
Missouri$4$1252,464-11.9%
Ohio$4$165656-12.5%
Tennessee$4$13212,758-12.5%
Alabama$4$9262,882-12.9%
Arkansas$4$95161-13.9%
Kansas$4$139438-15.4%
Illinois$4$312138-16.8%
Utah$4$123642-17.8%
West Virginia$4$1282,001-22.3%
Oregon$4$135400-26.4%

⚠️ 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