96405

Administration of chemotherapy into growth, 1-7

Medicare pricing data for 2,697 providers across 46 states

🤖AI Overview

Prices vary significantly by location — from $33 in Iowa to $83 in California. 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

Administration of chemotherapy into growth, 1-7 (HCPCS code 96405) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $68.70, but hospitals typically charge $197.08 — a 2.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.74

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $68.70, your out-of-pocket cost would be approximately $13.74. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$68.70
Average Hospital Charge
$197.08
Markup Ratio
2.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$197.08
Medicare Allowed$68.70
Medicare Payment$52.05

Hospitals charge 2.9x more than what Medicare allows for this procedure. Medicare actually pays $52.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$83$1922712,732+20.6%
Connecticut$79$22424114+15.5%
New Jersey$79$17742422+15.3%
Virginia$79$16963757+14.8%
Maryland$79$18161883+14.7%
Illinois$77$32744293+12.6%
Colorado$76$2031001,157+11.3%
Hawaii$76$1941162+10.4%
Minnesota$75$2511757+9.6%
New York$75$2931451,129+9.4%
Washington$75$19544297+9.2%
Wisconsin$74$48014191+8.4%
Nevada$73$17520196+7.0%
District of Columbia$73$165878+5.8%
Michigan$72$18467294+5.5%
Oregon$70$22822107+2.4%
Georgia$70$20965425+2.0%
Rhode Island$70$17923141+1.9%
Maine$69$3201065+0.9%
Wyoming$69$179937+0.8%
Missouri$69$21839216+0.3%
Ohio$68$16737233-0.4%
Arkansas$68$13522164-0.5%
Florida$67$1704275,553-2.0%
Oklahoma$67$16824166-2.3%
Kentucky$67$33732217-2.7%
Texas$65$1972192,360-4.8%
Vermont$65$168666-5.2%
Kansas$65$13628420-5.4%
New Hampshire$65$34217202-5.4%
Louisiana$65$13130185-6.1%
North Carolina$64$2181331,246-6.9%
Arizona$63$1801121,383-8.8%
Nebraska$63$1501169-9.0%
South Carolina$63$13854716-9.0%
New Mexico$62$15411147-9.2%
Tennessee$62$17455399-9.4%
Alabama$62$30044390-9.9%
Pennsylvania$61$16067391-10.8%
Indiana$61$17129116-10.9%
South Dakota$61$174626-11.0%
Idaho$59$13117148-14.4%
Utah$57$1801880-17.6%
Mississippi$55$12413411-19.5%
Massachusetts$53$19764493-22.8%
Iowa$33$51229227-52.6%

⚠️ 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

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