98926

Osteopathic manipulative treatment, 3-4 body regions

Medicare pricing data for 4,078 providers across 51 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

Osteopathic manipulative treatment, 3-4 body regions (HCPCS code 98926) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $43.48, but hospitals typically charge $103.17 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.70

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $43.48, your out-of-pocket cost would be approximately $8.70. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$43.48
Average Hospital Charge
$103.17
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$103.17
Medicare Allowed$43.48
Medicare Payment$32.76

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $32.76 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$53$202361,856+21.7%
District of Columbia$49$9731,282+13.7%
New York$49$1562016,815+12.9%
California$48$9829214,734+9.6%
Connecticut$47$187231,475+8.0%
New Jersey$46$1171243,494+6.3%
Rhode Island$45$1041380+3.9%
Virginia$45$73963,884+3.6%
Maryland$45$10822506+3.2%
Delaware$45$7713534+2.7%
Massachusetts$45$141691,058+2.5%
Pennsylvania$45$942443,157+2.3%
New Hampshire$44$10627500+2.3%
North Dakota$44$123241+1.4%
Illinois$44$1381231,788+1.3%
Wyoming$44$1101335+0.9%
Vermont$44$79345+0.6%
Florida$44$1092092,022+0.4%
Washington$44$1011691,550+0.3%
Utah$43$10134392-1.1%
Colorado$43$951342,081-1.4%
Arizona$42$891221,364-3.0%
Indiana$42$10993942-3.5%
Alabama$42$90728-3.6%
Idaho$42$12637457-4.3%
Oregon$42$92871,549-4.4%
Mississippi$42$86970-4.5%
Nebraska$41$949262-4.6%
Kansas$41$9129297-4.7%
North Carolina$41$9377625-4.9%
Hawaii$41$6613922-5.1%
Montana$41$9825197-5.2%
Nevada$41$116221,560-5.6%
New Mexico$41$77211,147-5.9%
Georgia$41$10040179-6.4%
Michigan$40$723394,507-6.9%
Ohio$40$1052832,889-7.1%
Missouri$40$841002,295-7.1%
Tennessee$40$7655455-7.3%
Minnesota$40$11677947-7.7%
South Carolina$40$11339136-8.4%
Wisconsin$40$1781661,419-9.1%
Kentucky$39$8348565-9.7%
Iowa$39$11671512-11.1%
West Virginia$38$9532149-11.5%
Texas$38$7615510,463-13.1%
Oklahoma$37$661072,579-14.1%
Maine$37$84107959-15.9%
Arkansas$36$9817365-18.1%
Louisiana$34$99658-21.7%
South Dakota$34$61237-22.6%

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

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