95874

Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle

Medicare pricing data for 3,892 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $19 in Vermont to $84 in Hawaii. 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

Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle (HCPCS code 95874) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $55.67, but hospitals typically charge $180.23 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$11.13

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $55.67, your out-of-pocket cost would be approximately $11.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$55.67
Average Hospital Charge
$180.23
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$180.23
Medicare Allowed$55.67
Medicare Payment$43.65

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $43.65 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Hawaii$84$18410186+50.5%
District of Columbia$82$19331811+47.5%
Connecticut$74$238511,647+33.7%
Wyoming$72$195860+29.8%
Arizona$69$186611,340+24.2%
Florida$69$1982436,867+23.1%
New York$67$2232365,887+20.9%
California$66$1893117,423+18.3%
New Jersey$64$1991041,835+15.5%
Colorado$64$162882,388+15.5%
Indiana$64$141971,992+15.3%
Texas$63$2071944,185+13.2%
Oregon$63$19357775+13.1%
Oklahoma$63$14926418+12.4%
Rhode Island$63$20312137+12.3%
Alabama$60$15033773+7.7%
Minnesota$57$2571253,821+2.5%
Maryland$57$134561,220+1.8%
Washington$56$1441263,428+0.1%
Pennsylvania$56$1312054,572-0.3%
Missouri$55$146952,913-0.3%
South Carolina$55$284631,490-1.1%
North Carolina$54$1711313,154-2.2%
Tennessee$54$164791,611-3.7%
Georgia$53$166861,985-5.1%
Illinois$52$1701693,943-7.1%
Nevada$51$39627613-7.9%
South Dakota$51$17119558-8.5%
Massachusetts$50$1681104,085-9.7%
Louisiana$48$15752776-13.1%
Utah$48$12928456-13.7%
Kansas$47$158351,239-15.6%
Ohio$47$1371783,970-15.8%
Michigan$46$1721802,685-16.5%
Virginia$46$113912,454-17.1%
New Mexico$43$12718264-22.1%
Montana$42$10920572-24.0%
Delaware$41$10914343-26.9%
Arkansas$40$11823471-28.0%
Idaho$40$8825379-28.5%
Mississippi$39$136231,338-30.8%
Wisconsin$38$3701063,235-32.2%
Iowa$37$138521,358-33.1%
Nebraska$36$11730980-35.5%
New Hampshire$34$11925676-38.8%
Kentucky$29$72531,175-47.6%
West Virginia$29$7320417-47.8%
Alaska$26$125228-53.2%
North Dakota$26$11819560-53.4%
Maine$21$6819365-62.3%
Vermont$19$5310287-65.3%

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

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