95149

Professional service for preparation and provision of 5 stinging insect venom

Medicare pricing data for 818 providers across 27 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 5 stinging insect venom (HCPCS code 95149) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $107.73, but hospitals typically charge $202.30 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.55

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $107.73, your out-of-pocket cost would be approximately $21.55. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$107.73
Average Hospital Charge
$202.30
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$202.30
Medicare Allowed$107.73
Medicare Payment$82.14

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $82.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$130$20027835+21.0%
Maryland$124$23731471+14.7%
Connecticut$120$21314263+11.7%
Massachusetts$120$34445819+11.1%
Washington$118$24028370+9.8%
Colorado$118$19711112+9.2%
Virginia$115$19335492+6.4%
Oregon$114$22813119+5.8%
California$114$18523341+5.7%
Arizona$110$20013208+2.0%
Texas$110$15216832+1.8%
Wisconsin$109$33616247+0.9%
North Carolina$106$235591,247-1.3%
Florida$106$17041861-1.5%
New York$105$22876824-2.3%
South Carolina$103$18829554-4.0%
Georgia$103$25823385-4.2%
Pennsylvania$103$148511,271-4.4%
Kentucky$101$2121091-6.5%
Illinois$100$13927397-7.6%
Tennessee$99$171411,005-8.3%
West Virginia$98$183973-9.1%
Alabama$97$12912164-9.6%
Indiana$96$18214213-10.5%
Ohio$93$22027311-13.4%
Vermont$91$92253-15.5%
Michigan$89$13336608-17.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber