96573

Application of light by qualified health care professional to destroy precancer skin growth

Medicare pricing data for 2,781 providers across 49 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

Application of light by qualified health care professional to destroy precancer skin growth (HCPCS code 96573) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $220.38, but hospitals typically charge $457.62 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$44.08

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $220.38, your out-of-pocket cost would be approximately $44.08. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$220.38
Average Hospital Charge
$457.62
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$457.62
Medicare Allowed$220.38
Medicare Payment$163.00

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $163.00 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$270$57014105+22.4%
California$264$4203274,866+19.9%
Hawaii$255$404962+15.5%
New York$250$5541531,525+13.5%
Connecticut$247$73242241+12.0%
New Jersey$243$42399686+10.2%
Maryland$242$50140728+9.6%
Massachusetts$241$64565809+9.5%
Washington$235$57431259+6.8%
New Hampshire$235$65714109+6.6%
Colorado$231$46856872+4.8%
Illinois$226$538100875+2.6%
Minnesota$224$56724118+1.7%
Nevada$222$50822214+0.6%
Wyoming$221$51311129+0.2%
Pennsylvania$219$395981,063-0.8%
Texas$218$3961501,621-1.0%
Oregon$216$54527241-1.8%
Virginia$216$36965794-1.9%
Montana$214$54615158-3.0%
Florida$212$4213973,827-3.6%
Rhode Island$212$5121061-3.7%
Michigan$210$45955244-4.7%
Maine$208$652563-5.7%
Ohio$206$48591876-6.5%
Louisiana$205$47035443-6.8%
South Dakota$205$52614225-6.9%
North Carolina$205$440691,114-7.0%
South Carolina$202$43923310-8.5%
Georgia$201$59179649-8.9%
Missouri$201$43653667-9.0%
North Dakota$200$441537-9.3%
Delaware$200$414419-9.4%
Arizona$198$364651,303-10.0%
Wisconsin$198$91528306-10.3%
New Mexico$197$445863-10.6%
Oklahoma$196$35022427-10.8%
Iowa$196$47531347-10.9%
Nebraska$193$43420362-12.4%
Indiana$193$416891,090-12.5%
Tennessee$192$32836371-12.8%
Kentucky$189$30529236-14.3%
Mississippi$189$56623263-14.5%
Alabama$188$40047350-14.6%
West Virginia$186$41620183-15.4%
Arkansas$184$29433210-16.4%
Utah$184$31844308-16.5%
Kansas$182$527491,617-17.6%
Idaho$181$28819114-17.7%

⚠️ 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