97024

Application of heat wave therapy

Medicare pricing data for 191 providers across 20 states

🤖AI Overview

This procedure has a 5.7x markup — hospitals charge $28.32 but Medicare allows only $4.94. Uninsured patients may face bills 5.7 times higher than what insurance negotiates. 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 heat wave therapy (HCPCS code 97024) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4.94, but hospitals typically charge $28.32 — a 5.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $4.94, your out-of-pocket cost would be approximately $0.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$4.94
Average Hospital Charge
$28.32
Markup Ratio
5.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$28.32
Medicare Allowed$4.94
Medicare Payment$3.84

Hospitals charge 5.7x more than what Medicare allows for this procedure. Medicare actually pays $3.84 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$6$5225949+17.0%
California$5$31284,592+10.9%
Missouri$5$102586+6.1%
Florida$5$8510296+4.9%
Illinois$5$14957+2.2%
Pennsylvania$5$1612597-0.6%
Massachusetts$5$136361-1.2%
Washington$5$73120-2.2%
New Hampshire$5$131479-2.4%
South Carolina$5$673184-5.1%
Oregon$5$133100-6.3%
Iowa$4$17187-9.1%
Alabama$4$3212352-10.3%
Ohio$4$9810352-11.1%
Arizona$4$175629-11.3%
Virginia$4$165647-11.5%
North Carolina$4$551189-12.6%
Mississippi$4$11121,937-14.0%
Arkansas$4$113692-14.4%
Texas$4$347313-14.6%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber