97034

Application of hot and cold baths, each 15 minutes

Medicare pricing data for 224 providers across 15 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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 hot and cold baths, each 15 minutes (HCPCS code 97034) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.01, but hospitals typically charge $31.21 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.20

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.01, your out-of-pocket cost would be approximately $2.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.01
Average Hospital Charge
$31.21
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$31.21
Medicare Allowed$11.01
Medicare Payment$8.54

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $8.54 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$12$357917+9.4%
New Jersey$12$4015152+7.9%
New York$12$501216+5.9%
California$12$1824915+5.1%
Pennsylvania$11$2713701+0.5%
Florida$11$26312,883-0.5%
Indiana$11$46216-1.8%
Virginia$11$13214192-3.3%
Utah$11$245150-4.4%
Louisiana$10$547162-6.4%
Alabama$10$2612234-6.7%
Texas$10$2512153-7.6%
Wyoming$10$337528-10.4%
Mississippi$10$4212121-11.2%
North Dakota$10$33164-11.6%

⚠️ 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