Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes
Medicare pricing data for 10,351 providers across 51 states
Prices vary significantly by location — from $11 in South Dakota to $23 in Maryland. Where you get this procedure matters more than almost any other factor. 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
Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes (HCPCS code 99421) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $14.23, but hospitals typically charge $42.26 — a 3.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $14.23, your out-of-pocket cost would be approximately $2.85. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $10.21 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Maryland | $23 | $43 | 269 | 1,842 | +58.4% |
| Alaska | $18 | $40 | 15 | 47 | +29.6% |
| District of Columbia | $16 | $34 | 21 | 169 | +15.6% |
| New Jersey | $16 | $42 | 63 | 629 | +11.7% |
| California | $16 | $60 | 1,337 | 13,466 | +9.1% |
| Connecticut | $15 | $64 | 15 | 77 | +7.2% |
| New York | $15 | $82 | 328 | 1,625 | +7.0% |
| Illinois | $15 | $41 | 432 | 3,182 | +5.7% |
| Delaware | $15 | $38 | 9 | 128 | +4.6% |
| Massachusetts | $15 | $53 | 87 | 242 | +2.3% |
| Wyoming | $15 | $45 | 9 | 30 | +1.9% |
| Vermont | $14 | $23 | 4 | 21 | +1.6% |
| Washington | $14 | $42 | 541 | 4,417 | +0.8% |
| Texas | $14 | $30 | 475 | 15,897 | +0.7% |
| Florida | $14 | $40 | 331 | 2,798 | +0.4% |
| Maine | $14 | $29 | 5 | 134 | -0.3% |
| Rhode Island | $14 | $57 | 4 | 14 | -0.5% |
| New Mexico | $14 | $34 | 17 | 97 | -0.8% |
| Minnesota | $14 | $50 | 1,001 | 3,028 | -3.0% |
| Hawaii | $14 | $38 | 47 | 226 | -3.2% |
| Montana | $14 | $39 | 41 | 204 | -3.5% |
| Oregon | $14 | $47 | 301 | 1,775 | -3.6% |
| Arizona | $14 | $30 | 106 | 517 | -3.9% |
| Georgia | $14 | $54 | 133 | 425 | -5.0% |
| Puerto Rico | $14 | $29 | 5 | 23 | -5.0% |
| South Carolina | $13 | $41 | 94 | 369 | -5.6% |
| Colorado | $13 | $37 | 52 | 203 | -6.0% |
| Virginia | $13 | $35 | 193 | 880 | -6.0% |
| Ohio | $13 | $39 | 1,172 | 5,566 | -6.3% |
| Nevada | $13 | $30 | 18 | 183 | -6.6% |
| Pennsylvania | $13 | $33 | 482 | 1,431 | -6.7% |
| North Carolina | $13 | $41 | 643 | 3,479 | -7.1% |
| Oklahoma | $13 | $32 | 114 | 2,814 | -8.0% |
| Alabama | $13 | $34 | 20 | 38 | -8.2% |
| Missouri | $13 | $43 | 96 | 857 | -9.3% |
| Idaho | $13 | $39 | 5 | 13 | -9.4% |
| Louisiana | $13 | $31 | 165 | 721 | -9.4% |
| Michigan | $13 | $39 | 665 | 3,770 | -9.4% |
| Tennessee | $13 | $31 | 193 | 1,240 | -9.5% |
| Wisconsin | $13 | $40 | 200 | 662 | -10.7% |
| Indiana | $12 | $38 | 67 | 453 | -12.3% |
| Kentucky | $12 | $28 | 61 | 403 | -12.4% |
| Kansas | $12 | $44 | 23 | 60 | -12.5% |
| Arkansas | $12 | $40 | 16 | 23 | -12.6% |
| Utah | $12 | $40 | 13 | 48 | -12.9% |
| Iowa | $12 | $46 | 201 | 780 | -13.1% |
| Mississippi | $12 | $21 | 46 | 315 | -13.4% |
| North Dakota | $12 | $44 | 23 | 48 | -14.1% |
| West Virginia | $12 | $37 | 48 | 193 | -15.2% |
| Nebraska | $12 | $40 | 80 | 3,779 | -16.8% |
| South Dakota | $11 | $42 | 24 | 124 | -20.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber