96920

Treatment of inflammatory skin disease using laser, less than 250.0 sq cm

Medicare pricing data for 1,927 providers across 38 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

Treatment of inflammatory skin disease using laser, less than 250.0 sq cm (HCPCS code 96920) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $156.07, but hospitals typically charge $356.70 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$31.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $156.07, your out-of-pocket cost would be approximately $31.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$156.07
Average Hospital Charge
$356.70
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$356.70
Medicare Allowed$156.07
Medicare Payment$122.04

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $122.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$173$4051806,763+11.1%
California$172$35122410,930+10.1%
District of Columbia$170$2595173+8.7%
New Jersey$169$4511003,077+8.5%
Massachusetts$169$503792,385+8.1%
Washington$165$31640912+5.4%
Colorado$163$28914191+4.3%
Maryland$160$389581,914+2.8%
Delaware$158$2338478+1.2%
Nevada$158$34211362+1.1%
Virginia$155$318461,775-0.5%
Minnesota$154$418551,620-1.2%
Pennsylvania$154$277832,763-1.3%
New Hampshire$151$56223319-3.0%
Illinois$151$3451082,895-3.2%
Texas$151$348992,981-3.3%
Florida$150$2832017,359-4.1%
Michigan$149$297461,399-4.6%
Connecticut$149$40613461-4.7%
Georgia$148$393511,562-5.4%
Maine$146$437681-6.2%
Nebraska$145$3306215-6.8%
Arizona$143$320431,733-8.1%
Alabama$142$53522480-9.0%
Kentucky$142$31115389-9.3%
North Carolina$141$29943892-9.6%
South Carolina$138$42219748-11.3%
Indiana$138$498461,163-11.6%
Wisconsin$137$50721618-12.2%
Oregon$137$40940714-12.4%
Tennessee$135$277701,743-13.2%
Iowa$134$38616380-14.4%
Ohio$133$25930484-14.7%
Mississippi$130$231191,343-16.9%
Missouri$129$43113347-17.4%
New Mexico$123$1953102-20.9%
Louisiana$122$3009777-21.9%
North Dakota$115$38310331-26.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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