Test for allergy using allergenic extract injected into skin with delayed reaction analysis
Medicare pricing data for 88 providers across 12 states
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 for allergy using allergenic extract injected into skin with delayed reaction analysis (HCPCS code 95028) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $13.67, but hospitals typically charge $25.56 — a 1.9x 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 $13.67, your out-of-pocket cost would be approximately $2.73. 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 1.9x more than what Medicare allows for this procedure. Medicare actually pays $10.58 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| California | $17 | $18 | 7 | 2,501 | +22.6% |
| New Jersey | $14 | $22 | 1 | 441 | +4.0% |
| Maryland | $13 | $19 | 2 | 253 | -3.6% |
| New Hampshire | $13 | $38 | 2 | 785 | -4.2% |
| Illinois | $12 | $84 | 4 | 274 | -8.6% |
| New York | $12 | $30 | 9 | 240 | -10.5% |
| Arizona | $12 | $56 | 6 | 130 | -10.9% |
| Texas | $12 | $34 | 20 | 1,092 | -11.0% |
| Florida | $12 | $16 | 2 | 493 | -11.6% |
| New Mexico | $11 | $14 | 2 | 325 | -16.7% |
| North Carolina | $11 | $19 | 9 | 430 | -16.9% |
| Tennessee | $11 | $14 | 4 | 309 | -20.5% |
⚠️ 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