95937

Testing of nerve-muscle junction

Medicare pricing data for 1,545 providers across 43 states

🤖AI Overview

This procedure has a 14.9x markup — hospitals charge $770.24 but Medicare allows only $51.85. Uninsured patients may face bills 14.9 times higher than what insurance negotiates. Prices vary significantly by location — from $32 in Iowa to $124 in District of Columbia. 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

Testing of nerve-muscle junction (HCPCS code 95937) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.85, but hospitals typically charge $770.24 — a 14.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.37

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.85, your out-of-pocket cost would be approximately $10.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.85
Average Hospital Charge
$770.24
Markup Ratio
14.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$770.24
Medicare Allowed$51.85
Medicare Payment$41.07

Hospitals charge 14.9x more than what Medicare allows for this procedure. Medicare actually pays $41.07 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$124$179522+138.9%
Minnesota$95$59360376+83.8%
Delaware$90$1183108+74.5%
Missouri$86$25032257+65.1%
Louisiana$85$11013118+63.6%
Mississippi$84$262850+62.8%
New York$82$470107474+58.5%
Alabama$76$32920147+46.2%
South Carolina$74$1762283+43.5%
California$65$7661437,728+24.6%
Oklahoma$64$175532+24.2%
Indiana$63$24936165+21.2%
New Jersey$62$74137516+20.2%
Connecticut$60$1962068+16.6%
Florida$60$3701202,081+14.9%
New Hampshire$59$294947+14.6%
Virginia$48$3,85535563-7.3%
Texas$48$1731092,159-7.4%
Oregon$46$28718131-11.1%
Alaska$45$7401374-13.3%
Michigan$45$62861723-13.3%
Massachusetts$43$15551443-17.4%
Illinois$43$65861596-18.0%
Arizona$42$2,946371,196-19.2%
Colorado$41$1,32619425-21.1%
Kentucky$41$1132090-21.2%
Maryland$40$252562,601-22.3%
North Carolina$40$24641727-23.2%
Pennsylvania$39$76861612-24.2%
Ohio$39$2,55476680-24.3%
Utah$39$4,95219583-24.4%
Georgia$39$11538798-25.5%
Washington$38$120311,292-25.9%
Nevada$38$130121,270-26.8%
Tennessee$38$31735915-27.5%
Kansas$37$18822283-28.6%
Wisconsin$37$96220228-29.0%
West Virginia$33$99762-36.1%
Vermont$33$179414-36.3%
South Dakota$33$35376-36.7%
Maine$32$223311-37.9%
Nebraska$32$146596-37.9%
Iowa$32$212952-38.3%

⚠️ 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