95076

Test for allergy using ingested items, initial 2 hours

Medicare pricing data for 2,285 providers across 48 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 ingested items, initial 2 hours (HCPCS code 95076) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $118.51, but hospitals typically charge $327.56 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$23.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $118.51, your out-of-pocket cost would be approximately $23.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$118.51
Average Hospital Charge
$327.56
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$327.56
Medicare Allowed$118.51
Medicare Payment$91.05

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $91.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$151$545974+27.5%
California$135$332193952+14.0%
New Jersey$132$291104532+11.7%
New York$131$3961891,042+10.8%
District of Columbia$129$290630+8.7%
Maryland$125$22658231+5.8%
Washington$123$32242142+3.7%
Rhode Island$121$190840+2.5%
Illinois$121$389101567+2.3%
Colorado$120$27442136+1.0%
Virginia$120$25779315+0.9%
Nevada$120$2441132+0.9%
New Hampshire$119$319728+0.5%
Vermont$119$268123+0.4%
Delaware$117$29313100-1.0%
Minnesota$117$43247123-1.1%
Texas$117$259159411-1.2%
Missouri$117$33034122-1.3%
Massachusetts$117$391101614-1.3%
Georgia$116$32249157-1.7%
Oregon$116$3532079-1.9%
Florida$116$291145833-1.9%
Connecticut$115$32640188-2.7%
Kansas$113$2651575-4.3%
Arizona$113$28653281-4.4%
South Dakota$113$152635-4.9%
Michigan$113$23366203-5.0%
North Carolina$112$32689350-5.8%
Pennsylvania$111$23897456-6.0%
Indiana$111$2762794-6.4%
Utah$111$2271965-6.6%
South Carolina$110$25835130-6.8%
New Mexico$110$231727-7.4%
Kentucky$109$2583297-8.0%
Iowa$108$27023161-8.5%
Mississippi$108$2581987-8.5%
Oklahoma$108$2351432-8.7%
Arkansas$108$1981319-8.7%
Louisiana$108$2132271-8.8%
Idaho$108$2921657-9.2%
Tennessee$107$30275330-9.4%
Alabama$106$1952160-10.3%
Maine$105$224626-11.6%
Wisconsin$102$68944293-13.7%
West Virginia$100$2581262-15.7%
Ohio$98$40384440-17.5%
Montana$96$208818-19.1%
Nebraska$85$3711343-28.0%

⚠️ 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