95813

Measurement of brain wave activity (eeg), 61-119 minutes

Medicare pricing data for 2,406 providers across 47 states

🤖AI Overview

Prices vary significantly by location — from $77 in Arkansas to $369 in New Jersey. Where you get this procedure matters more than almost any other factor. 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

Measurement of brain wave activity (eeg), 61-119 minutes (HCPCS code 95813) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $197.17, but hospitals typically charge $737.85 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$39.43

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $197.17, your out-of-pocket cost would be approximately $39.43. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$197.17
Average Hospital Charge
$737.85
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$737.85
Medicare Allowed$197.17
Medicare Payment$154.10

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $154.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$369$1,038841,667+87.0%
Nevada$355$66021167+80.1%
Maryland$325$77457594+65.0%
Arizona$310$61841527+57.2%
Minnesota$308$1,24464461+56.3%
Delaware$301$7231175+52.9%
Florida$277$7721671,561+40.5%
California$267$7852042,333+35.6%
Texas$249$8871773,128+26.4%
Alabama$243$44025150+23.5%
Louisiana$220$94340285+11.5%
New York$209$7771952,211+6.1%
Idaho$207$558826+4.8%
North Carolina$192$55563265-2.4%
Tennessee$182$54862343-7.5%
Indiana$174$35837214-12.0%
Georgia$164$1,16865743-16.9%
Michigan$155$80689603-21.3%
Kansas$137$39922332-30.7%
Wisconsin$126$86146276-35.9%
Oklahoma$125$35922191-36.7%
Utah$124$4,41322390-36.9%
Massachusetts$123$405621,703-37.5%
Ohio$119$443123770-39.5%
Illinois$116$617110623-41.2%
Alaska$112$2,849255-43.0%
Washington$110$31139607-44.3%
South Carolina$106$27539868-46.2%
Kentucky$96$26938383-51.3%
Virginia$95$39641171-51.8%
Colorado$95$40747449-52.1%
District of Columbia$93$97311105-52.9%
Missouri$92$31652741-53.1%
Pennsylvania$91$426103741-53.9%
Connecticut$89$39231394-54.9%
Oregon$87$5131130-55.9%
Rhode Island$85$2871024-56.9%
Montana$84$232815-57.5%
North Dakota$83$522712-57.7%
New Hampshire$83$5672295-57.9%
New Mexico$82$4081299-58.2%
West Virginia$80$3001494-59.2%
Mississippi$80$50815424-59.4%
South Dakota$80$3111036-59.5%
Nebraska$80$31410109-59.6%
Iowa$80$45119425-59.6%
Arkansas$77$71014114-60.9%

⚠️ 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