95957

Measurement of brain wave activity (eeg), digital analysis

Medicare pricing data for 797 providers across 34 states

🤖AI Overview

Prices vary significantly by location — from $89 in Wisconsin to $321 in Maryland. 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), digital analysis (HCPCS code 95957) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $258.28, but hospitals typically charge $523.34 — a 2.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$51.66

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $258.28, your out-of-pocket cost would be approximately $51.66. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$258.28
Average Hospital Charge
$523.34
Markup Ratio
2.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$523.34
Medicare Allowed$258.28
Medicare Payment$205.23

Hospitals charge 2.0x more than what Medicare allows for this procedure. Medicare actually pays $205.23 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$321$569152,697+24.1%
New York$311$558602,945+20.4%
Virginia$295$8948144+14.1%
California$292$5391056,509+13.0%
Washington$285$763579+10.2%
Delaware$276$683335+6.8%
New Jersey$269$506431,105+4.1%
Puerto Rico$268$28916124+4.0%
Connecticut$266$465313+3.1%
Arizona$265$46016480+2.8%
North Carolina$259$48417643+0.4%
Ohio$259$67516227+0.4%
South Carolina$255$6874128-1.2%
Georgia$255$56321639-1.2%
Oregon$255$1,010374-1.3%
Florida$250$58339479-3.2%
Tennessee$244$41711453-5.5%
Mississippi$242$5493466-6.4%
Michigan$235$48514494-9.1%
Missouri$231$40610404-10.7%
Texas$227$5332357,090-12.2%
West Virginia$220$342211-14.9%
Kentucky$219$357223-15.4%
Nevada$212$395321,573-18.1%
Oklahoma$202$4539397-21.9%
Massachusetts$194$300430-24.7%
Illinois$171$48813277-33.7%
Louisiana$164$28510202-36.5%
Indiana$158$53510406-38.9%
Pennsylvania$143$32811176-44.5%
Utah$118$5226291-54.3%
Idaho$94$2054220-63.5%
Arkansas$93$216246-63.9%
Wisconsin$89$1,0221123-65.5%

⚠️ 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