96922

Treatment of inflammatory skin disease using laser, more than 500.0 sq cm

Medicare pricing data for 619 providers across 17 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, more than 500.0 sq cm (HCPCS code 96922) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $247.79, but hospitals typically charge $564.58 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$49.56

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $247.79, your out-of-pocket cost would be approximately $49.56. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$247.79
Average Hospital Charge
$564.58
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$564.58
Medicare Allowed$247.79
Medicare Payment$195.48

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $195.48 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$267$720682,727+7.6%
California$265$5631143,997+7.1%
Maryland$252$39112376+1.6%
New Jersey$251$52738956+1.4%
Pennsylvania$240$30615101-3.3%
Minnesota$234$54513180-5.7%
Massachusetts$233$90018201-6.0%
Texas$232$51038457-6.5%
Virginia$229$48815229-7.6%
Illinois$226$59822195-9.0%
Florida$224$458802,567-9.8%
Washington$223$447569-9.9%
Georgia$223$55020284-10.1%
Arizona$221$49512141-10.7%
Michigan$221$4731588-10.8%
Ohio$214$44613101-13.6%
Tennessee$202$4083497-18.4%

⚠️ 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