95921

Testing of autonomic nervous system function and heart rate response to deep breathing

Medicare pricing data for 1,535 providers across 40 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

Testing of autonomic nervous system function and heart rate response to deep breathing (HCPCS code 95921) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $89.97, but hospitals typically charge $224.44 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$17.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $89.97, your out-of-pocket cost would be approximately $17.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$89.97
Average Hospital Charge
$224.44
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$224.44
Medicare Allowed$89.97
Medicare Payment$69.11

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $69.11 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$101$25723816,253+12.0%
New Jersey$98$227732,289+8.5%
California$93$16511410,333+3.4%
Connecticut$93$26913311+3.2%
Maryland$91$273472,152+1.0%
Massachusetts$89$2494306-0.8%
Illinois$89$24215221-0.8%
Puerto Rico$88$149416-1.8%
Nevada$86$233332,629-4.6%
Delaware$85$18515344-5.1%
Florida$85$250692,502-5.3%
Texas$85$2302677,486-5.5%
Wisconsin$85$232218-5.6%
Michigan$84$1521071-6.4%
Georgia$84$260782,577-6.5%
Pennsylvania$83$39028570-8.1%
Indiana$83$260676-8.2%
Virginia$82$219371,611-8.6%
North Carolina$81$189761,751-9.7%
Nebraska$81$3376235-10.3%
South Carolina$80$194341,281-11.0%
Utah$79$25415199-11.8%
Kentucky$79$221746-12.0%
Tennessee$79$17533300-12.1%
Ohio$79$187580-12.2%
Alabama$79$13218358-12.2%
Hawaii$79$161431-12.6%
Arizona$78$1841284,299-13.7%
Colorado$77$1871172-14.3%
Arkansas$77$1747243-14.5%
Louisiana$76$20114230-15.6%
Oklahoma$76$17618314-16.0%
New Mexico$74$2191130-17.4%
Mississippi$74$26728673-17.9%
Montana$73$143252-18.8%
Idaho$73$200876-19.0%
Washington$73$16011165-19.3%
Minnesota$72$1724176-20.3%
Kansas$71$262359-21.3%
Missouri$66$1919146-26.2%

⚠️ 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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