G0498

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l

Medicare pricing data for 3,530 providers across 46 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

Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted l (HCPCS code G0498) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $187.34, but hospitals typically charge $723.38 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$37.47

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $187.34, your out-of-pocket cost would be approximately $37.47. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$187.34
Average Hospital Charge
$723.38
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$723.38
Medicare Allowed$187.34
Medicare Payment$148.58

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $148.58 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Connecticut$273$76523347+45.8%
New York$270$7681603,146+44.3%
New Hampshire$269$88810289+43.8%
Massachusetts$262$50918355+39.8%
Minnesota$258$8681172,036+37.5%
Illinois$255$1,0341996,268+36.0%
Wisconsin$246$1,17843441+31.2%
Maine$230$33617297+22.7%
West Virginia$229$5613122+22.5%
Virginia$223$7601383,415+19.0%
South Carolina$219$58428823+16.7%
Georgia$218$571531,678+16.5%
Alabama$215$1,812762,360+15.0%
North Carolina$214$727661,204+14.2%
Tennessee$205$7731453,671+9.6%
California$194$7672846,354+3.6%
Alaska$191$80618521+2.2%
Maryland$191$639731,486+1.7%
New Jersey$189$751491,354+1.0%
Delaware$176$98612533-5.8%
Nevada$174$768541,561-6.9%
Pennsylvania$173$714881,890-7.9%
Washington$171$44154743-8.7%
North Dakota$170$5908116-9.3%
Colorado$170$984501,029-9.4%
Wyoming$169$5706205-9.8%
Florida$168$65041213,180-10.5%
Oregon$168$86151554-10.6%
Arizona$166$6201593,537-11.2%
South Dakota$162$7437135-13.5%
Ohio$162$6531062,247-13.7%
Utah$160$39924353-14.4%
Texas$160$49550312,658-14.5%
Missouri$159$850982,172-15.3%
Idaho$158$4597140-15.6%
Michigan$158$439441,093-15.9%
Kentucky$156$3907136-16.7%
New Mexico$156$68723419-16.9%
Louisiana$151$70620341-19.2%
Oklahoma$148$92721523-20.9%
Mississippi$147$577261,289-21.5%
Indiana$146$679631,588-22.0%
Nebraska$146$347371,027-22.1%
Arkansas$145$1,072281,168-22.4%
Kansas$143$535492,036-23.8%
Iowa$142$509471,443-24.4%

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

Related from TheDataProject.ai

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