95145

Professional service for preparation and provision of 1 stinging insect venom

Medicare pricing data for 890 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

Professional service for preparation and provision of 1 stinging insect venom (HCPCS code 95145) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $32.87, but hospitals typically charge $58.62 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $32.87, your out-of-pocket cost would be approximately $6.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$32.87
Average Hospital Charge
$58.62
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$58.62
Medicare Allowed$32.87
Medicare Payment$24.27

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $24.27 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$39$55532,060+18.0%
New Jersey$38$5429355+14.2%
Alaska$37$97798+13.4%
Maryland$37$5723189+12.1%
California$37$59691,146+11.5%
Connecticut$36$7513124+9.0%
Washington$35$7129333+7.0%
Massachusetts$34$9231320+2.5%
Pennsylvania$33$5643640+1.7%
Minnesota$33$10420400+1.1%
Virginia$33$5142493+0.8%
Oregon$33$11416163+0.5%
Colorado$32$426139-1.2%
Texas$32$49551,153-4.0%
Florida$31$46541,117-4.4%
Missouri$31$4810193-4.9%
Georgia$31$8122280-5.9%
Wisconsin$31$10719221-7.0%
South Carolina$30$5528509-7.9%
North Carolina$30$5540745-8.2%
Indiana$30$5612182-9.1%
Louisiana$30$4910131-10.1%
Tennessee$30$5528396-10.1%
Illinois$30$5218371-10.2%
Kentucky$29$5110145-10.8%
Arizona$29$6315236-11.0%
Ohio$29$5129260-12.2%
Michigan$29$5025262-12.7%
Arkansas$29$4912197-13.3%
Alabama$28$4012145-13.8%
Mississippi$28$5013275-15.1%
Idaho$28$6111212-16.2%
Montana$27$45688-18.6%

⚠️ 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