A0434

Specialty care transport (sct)

Medicare pricing data for 1,202 providers across 47 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

Specialty care transport (sct) (HCPCS code A0434) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $895.49, but hospitals typically charge $3,612 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$179.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $895.49, your out-of-pocket cost would be approximately $179.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$895.49
Average Hospital Charge
$3,612
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3,611.68
Medicare Allowed$895.49
Medicare Payment$711.53

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $711.53 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Wyoming$1,045$3,105615+16.7%
South Dakota$1,005$1,333429+12.3%
Montana$997$2,47712107+11.3%
California$986$5,3328811,468+10.1%
Alaska$976$4,585494+9.0%
Minnesota$971$2,984271,123+8.5%
New York$971$2,306614,632+8.4%
Colorado$967$3,68926259+8.0%
New Jersey$956$3,71474,646+6.8%
Hawaii$956$2,696131+6.7%
Oregon$933$4,282261,322+4.2%
Washington$929$2,709181,828+3.8%
Massachusetts$929$4,955364,029+3.8%
Maryland$927$2,173152,555+3.6%
Connecticut$927$2,11012799+3.5%
New Hampshire$897$4,49712472+0.2%
Arizona$882$1,343201,098-1.5%
Idaho$880$1,45125540-1.7%
Vermont$873$2,02516322-2.5%
Nevada$870$2,01311902-2.8%
Pennsylvania$870$2,63830981-2.9%
Illinois$862$6,040596,168-3.7%
Utah$862$2,29113418-3.8%
Maine$854$2,37134749-4.7%
Texas$852$3,334823,354-4.9%
Wisconsin$849$3,727392,486-5.2%
Virginia$844$2,98615582-5.8%
Nebraska$844$2,0947545-5.8%
Florida$838$1,503543,503-6.4%
Michigan$838$3,226473,230-6.4%
New Mexico$832$1,0636261-7.1%
Georgia$832$3,26240903-7.1%
Iowa$826$1,8671051-7.8%
Kansas$825$2,6574106-7.9%
Missouri$824$2,18918306-7.9%
North Carolina$824$1,676411,313-8.0%
Ohio$815$4,695271,085-9.0%
South Carolina$811$2,3029503-9.4%
Indiana$808$4,430191,168-9.8%
Oklahoma$805$1,592121,282-10.1%
Arkansas$804$2,04920739-10.2%
Alabama$802$1,18135674-10.4%
Tennessee$801$3,78046571-10.6%
Louisiana$798$4,283101,589-10.9%
Kentucky$791$2,05338459-11.7%
West Virginia$791$2,22738993-11.7%
Mississippi$784$2,09513648-12.4%

⚠️ 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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