96417

Administration of additional new drug or substance into vein, 1 hour or less

Medicare pricing data for 5,583 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

Administration of additional new drug or substance into vein, 1 hour or less (HCPCS code 96417) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $63.87, but hospitals typically charge $253.21 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.77

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $63.87, your out-of-pocket cost would be approximately $12.77. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$63.87
Average Hospital Charge
$253.21
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$253.21
Medicare Allowed$63.87
Medicare Payment$50.77

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $50.77 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$75$27968839,603+16.7%
District of Columbia$73$28812266+14.0%
New Jersey$72$2411569,223+13.4%
New York$72$29030212,596+12.2%
Maryland$71$23814612,575+10.9%
Alaska$70$339181,643+8.8%
Connecticut$69$259341,100+8.6%
Hawaii$69$1337110+7.8%
Massachusetts$68$22131813+6.8%
Vermont$66$2284370+4.1%
Rhode Island$66$224226+3.3%
Washington$66$2111315,154+3.3%
Montana$65$241319+2.3%
Colorado$65$331893,660+2.3%
Delaware$65$392151,329+2.0%
New Hampshire$65$24614676+1.9%
Pennsylvania$65$2241598,920+1.1%
Virginia$64$32117914,500+0.9%
Minnesota$64$3271776,002+0.1%
Wyoming$64$3428512-0.2%
Oregon$63$313702,668-0.7%
Nevada$63$276734,879-0.8%
Illinois$63$30727617,253-1.1%
Maine$63$26020991-1.3%
Florida$62$20252038,348-2.5%
Michigan$62$1661065,879-3.0%
Texas$62$29365338,740-3.0%
South Dakota$62$3897231-3.3%
Arizona$62$23818311,867-3.6%
North Dakota$61$1999301-4.3%
Missouri$61$2681506,573-5.2%
Wisconsin$60$415601,754-6.3%
North Carolina$60$241894,417-6.7%
New Mexico$60$251442,133-6.7%
Puerto Rico$59$6448742-7.4%
Utah$59$175381,411-7.5%
Nebraska$59$153574,010-8.0%
South Carolina$59$198646,078-8.1%
Ohio$59$2531486,942-8.3%
Indiana$58$243764,365-9.1%
Iowa$58$180663,952-9.2%
Kansas$58$222584,859-9.3%
Georgia$58$237997,332-9.5%
Idaho$58$1869764-9.6%
Oklahoma$57$144272,083-10.3%
West Virginia$57$1453301-10.3%
Tennessee$57$20518911,349-11.0%
Kentucky$57$19424906-11.1%
Alabama$56$2411156,820-11.8%
Louisiana$56$263422,266-11.9%
Arkansas$55$212507,119-13.9%
Mississippi$54$192273,591-15.7%

⚠️ 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