95147

Professional service for preparation and provision of 3 stinging insect venom

Medicare pricing data for 689 providers across 24 states

🤖AI Overview

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

Professional service for preparation and provision of 3 stinging insect venom (HCPCS code 95147) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $57.55, but hospitals typically charge $113.06 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $57.55, your out-of-pocket cost would be approximately $11.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$57.55
Average Hospital Charge
$113.06
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$113.06
Medicare Allowed$57.55
Medicare Payment$43.03

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $43.03 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$69$12729240+19.2%
California$66$9841626+14.0%
Connecticut$65$15113144+12.6%
New York$65$12450466+12.2%
Maryland$63$11333222+9.6%
Washington$61$12027230+6.7%
Minnesota$59$18519269+3.1%
Oregon$59$20311103+2.8%
Massachusetts$58$15734397+0.9%
Pennsylvania$57$9241458-1.1%
Virginia$57$9530338-1.7%
Georgia$56$17218220-2.0%
Illinois$56$11119170-2.3%
Florida$56$9840731-2.9%
Texas$55$7725380-4.2%
Michigan$55$9526594-5.3%
Wisconsin$54$18211121-5.3%
North Carolina$54$10945540-5.8%
Ohio$54$9617220-7.0%
Indiana$53$14515113-7.3%
South Carolina$53$9720377-8.8%
Idaho$52$1298100-8.9%
Arizona$52$1241286-10.3%
Tennessee$52$9919169-10.3%

⚠️ 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