96374

Injection of drug or substance into vein

Medicare pricing data for 15,679 providers across 52 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

Injection of drug or substance into vein (HCPCS code 96374) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $37.54, but hospitals typically charge $153.48 — a 4.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$7.51

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $37.54, your out-of-pocket cost would be approximately $7.51. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$37.54
Average Hospital Charge
$153.48
Markup Ratio
4.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$153.48
Medicare Allowed$37.54
Medicare Payment$29.25

Hospitals charge 4.1x more than what Medicare allows for this procedure. Medicare actually pays $29.25 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$43$15599221,278+15.0%
California$43$1421,82441,961+13.5%
District of Columbia$42$13569264+12.9%
New Jersey$42$1624375,501+11.0%
Hawaii$40$9749497+7.6%
Connecticut$40$25582722+5.5%
Maryland$39$1423644,409+4.9%
Alaska$39$28981474+4.6%
Colorado$39$1683742,078+3.1%
Massachusetts$39$1683672,540+3.0%
Virginia$37$1604495,562-0.2%
Puerto Rico$37$11121132-0.6%
New Hampshire$37$21455392-2.1%
Nevada$37$2231795,213-2.7%
Rhode Island$36$12826232-3.3%
Illinois$36$17470113,378-3.5%
Pennsylvania$36$1454343,465-3.8%
Minnesota$36$1874211,815-3.9%
North Dakota$36$144861,017-4.0%
Washington$36$1625152,122-4.8%
Florida$36$1551,19833,852-4.9%
Oregon$36$1481912,229-5.1%
South Dakota$36$18352215-5.2%
Texas$35$1551,17015,201-5.7%
Michigan$35$1172392,690-6.1%
Maine$35$17055535-6.2%
Arizona$35$1974427,228-6.5%
Delaware$35$17039402-7.8%
Vermont$34$99873-8.5%
Wisconsin$34$2302732,058-8.7%
North Carolina$34$1326154,331-9.6%
Ohio$34$1262993,886-9.7%
Montana$34$15354285-10.4%
Nebraska$34$1141531,465-10.5%
Missouri$34$1603512,516-10.6%
Wyoming$34$14472531-10.7%
Kansas$33$1291511,231-10.9%
Iowa$33$173153842-11.1%
Indiana$33$1701872,252-11.8%
Georgia$33$1274264,875-12.0%
Louisiana$33$1311952,396-12.2%
Tennessee$33$1593734,487-12.5%
West Virginia$33$10845522-12.8%
South Carolina$33$1243394,277-13.4%
Alabama$32$1222633,284-14.1%
Kentucky$32$129105807-14.3%
New Mexico$32$1171081,623-14.4%
Idaho$32$10369599-15.6%
Arkansas$32$1271241,873-15.6%
Oklahoma$31$112133740-16.4%
Mississippi$31$133120829-16.5%
Utah$31$92130561-17.7%

⚠️ 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