96361

Infusion into a vein for hydration, each additional hour

Medicare pricing data for 11,342 providers across 52 states

🤖AI Overview

This procedure has a 5.6x markup — hospitals charge $71.92 but Medicare allows only $12.91. Uninsured patients may face bills 5.6 times higher than what insurance negotiates. 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

Infusion into a vein for hydration, each additional hour (HCPCS code 96361) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $12.91, but hospitals typically charge $71.92 — a 5.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.58

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $12.91, your out-of-pocket cost would be approximately $2.58. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$12.91
Average Hospital Charge
$71.92
Markup Ratio
5.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$71.92
Medicare Allowed$12.91
Medicare Payment$10.18

Hospitals charge 5.6x more than what Medicare allows for this procedure. Medicare actually pays $10.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$15$512081+14.6%
New York$15$7263623,216+12.6%
California$14$731,19279,734+11.1%
New Jersey$14$10628912,412+9.7%
Maryland$14$562459,946+8.0%
Hawaii$14$4218478+7.5%
Alaska$14$109831,422+6.4%
Connecticut$14$10749819+5.3%
Massachusetts$13$551712,468+3.6%
Rhode Island$13$4814537+2.5%
Vermont$13$744198+2.2%
Pennsylvania$13$652147,677-1.1%
Colorado$13$652051,936-1.3%
Virginia$13$653017,861-1.7%
Washington$13$463065,386-2.0%
Delaware$13$6719201-2.1%
Minnesota$13$783614,123-2.6%
Puerto Rico$13$2536749-2.6%
Illinois$13$10650413,756-2.7%
Nevada$13$551493,483-2.9%
Florida$12$4991546,177-3.8%
New Hampshire$12$9337662-4.3%
Oregon$12$58112823-4.4%
Maine$12$5639857-5.9%
Texas$12$681,04519,986-5.9%
Arizona$12$1032836,855-6.0%
South Dakota$12$9959458-6.6%
North Dakota$12$4344855-6.7%
Michigan$12$412214,693-7.1%
North Carolina$12$533905,284-8.5%
New Mexico$12$53801,229-8.8%
Missouri$12$842975,585-8.8%
Wisconsin$12$1131651,212-8.8%
Ohio$12$602455,570-9.3%
South Carolina$12$12424120,232-9.7%
Montana$12$663393-9.8%
Georgia$12$783385,178-9.9%
Nebraska$12$34983,699-10.3%
Wyoming$11$6754351-11.0%
West Virginia$11$3113337-11.1%
Louisiana$11$891312,146-11.5%
Kansas$11$711234,458-11.6%
Tennessee$11$713848,223-11.7%
Indiana$11$531383,718-11.8%
Iowa$11$411513,456-11.8%
Oklahoma$11$34971,148-11.9%
Utah$11$411311,488-12.6%
Idaho$11$3843287-13.1%
Alabama$11$722586,472-13.4%
Kentucky$11$621021,337-13.9%
Arkansas$11$501103,569-14.1%
Mississippi$11$961251,038-16.0%

⚠️ 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