99091

Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days

Medicare pricing data for 777 providers across 32 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

Collection and interpretation of physical parameters stored in computers and/or transmitted by the patient and/or caregiver to qualified health care professional, requiring 30 minutes or more, per 30 days (HCPCS code 99091) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $54.11, but hospitals typically charge $115.61 — a 2.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.82

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $54.11, your out-of-pocket cost would be approximately $10.82. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$54.11
Average Hospital Charge
$115.61
Markup Ratio
2.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$115.61
Medicare Allowed$54.11
Medicare Payment$41.38

Hospitals charge 2.1x more than what Medicare allows for this procedure. Medicare actually pays $41.38 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$59$95275+9.1%
New Jersey$58$146407,836+7.2%
New York$58$110261,060+6.5%
Maryland$58$806167+6.3%
California$57$11010217,212+5.8%
Pennsylvania$56$16810278+2.8%
Florida$55$106423,213+2.3%
Hawaii$55$65214+2.3%
Virginia$55$1517293+2.1%
Michigan$54$127261,304+0.6%
Massachusetts$54$88449-0.1%
Missouri$53$1718433-1.3%
Arizona$53$106361,402-1.9%
Georgia$53$84229,333-2.0%
Illinois$53$111251,357-2.3%
Ohio$52$619451-3.0%
Texas$52$13025116,940-3.9%
Colorado$52$1361381-4.1%
Louisiana$52$17821256-4.3%
Delaware$52$102511-4.4%
North Carolina$51$113121,947-4.9%
Oklahoma$51$1217945-5.3%
Alabama$51$10213409-5.3%
Nevada$51$92131,921-5.5%
West Virginia$51$762484-5.5%
Kansas$51$1002309-6.3%
South Carolina$49$89514-9.8%
Arkansas$46$101690-14.8%
Oregon$44$1655199-18.3%
Wisconsin$44$110174-18.7%
Tennessee$44$1566785-18.8%
Mississippi$44$76131,419-19.1%

⚠️ 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

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