95976

Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming

Medicare pricing data for 1,602 providers across 45 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Electronic analysis of neurostimulator generator with simple cranial nerve stimulator programming (HCPCS code 95976) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $37.31, but hospitals typically charge $154.39 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $37.31, your out-of-pocket cost would be approximately $7.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$37.31
Average Hospital Charge
$154.39
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$154.39
Medicare Allowed$37.31
Medicare Payment$27.60

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $27.60 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$45$1,0111141+21.7%
New Jersey$42$14120138+12.3%
Connecticut$42$1881264+11.3%
New York$41$28876330+11.1%
Maryland$41$1242494+9.3%
Massachusetts$41$16414100+9.1%
California$40$143101458+8.5%
Washington$40$11025108+6.0%
Illinois$39$19641169+5.7%
Florida$39$129113974+5.0%
Wyoming$39$161516+4.7%
Virginia$39$14941231+3.9%
Texas$39$127137799+3.4%
Pennsylvania$38$13351233+2.9%
Wisconsin$38$1531173+1.9%
Nevada$38$1041143+1.1%
Maine$38$90722+0.6%
South Carolina$37$12134185-0.1%
Ohio$37$10962298-0.6%
Louisiana$37$13718154-0.9%
Oregon$37$1471650-1.2%
Michigan$37$9050198-1.4%
Montana$37$1011045-1.7%
North Carolina$37$28675562-1.8%
Arizona$36$7244432-2.3%
Minnesota$36$40051141-3.2%
Colorado$36$14654206-3.3%
Indiana$36$16578517-3.5%
Iowa$36$17015247-3.7%
Georgia$36$17164317-4.1%
Alabama$36$7918102-4.5%
North Dakota$35$49325-5.1%
New Mexico$35$195526-5.1%
Oklahoma$35$1232258-5.5%
West Virginia$35$102724-6.5%
Kentucky$35$14639222-6.8%
Mississippi$35$11521106-7.1%
Kansas$35$9928208-7.2%
Utah$34$10441224-7.6%
South Dakota$34$185865-8.2%
Tennessee$34$12130137-9.2%
Missouri$34$10144324-9.8%
Nebraska$34$17321240-9.8%
Idaho$33$9713100-10.5%
Arkansas$32$1041375-14.5%

⚠️ 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