Unclassified drugs
Medicare pricing data for 10,277 providers across 52 states
Prices vary significantly by location — from $8 in Vermont to $2,420 in West Virginia. 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
Unclassified drugs (HCPCS code J3490) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $272.81, but hospitals typically charge $626.17 — a 2.3x 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 $272.81, your out-of-pocket cost would be approximately $54.56. 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 2.3x more than what Medicare allows for this procedure. Medicare actually pays $217.07 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| West Virginia | $2,420 | $2,987 | 7 | 129 | +787.0% |
| District of Columbia | $1,588 | $2,823 | 16 | 115 | +482.2% |
| South Dakota | $1,404 | $2,026 | 24 | 724 | +414.5% |
| Connecticut | $1,349 | $2,329 | 69 | 1,542 | +394.4% |
| Delaware | $1,164 | $2,140 | 34 | 685 | +326.7% |
| Utah | $763 | $1,631 | 123 | 8,458 | +179.7% |
| Idaho | $739 | $1,601 | 49 | 2,827 | +170.8% |
| Oregon | $715 | $2,359 | 155 | 4,557 | +162.2% |
| Louisiana | $643 | $1,364 | 126 | 2,514 | +135.8% |
| South Carolina | $611 | $1,129 | 177 | 6,938 | +123.9% |
| Maryland | $569 | $1,174 | 270 | 16,158 | +108.7% |
| North Carolina | $557 | $1,088 | 313 | 5,301 | +104.0% |
| Ohio | $544 | $1,029 | 242 | 10,796 | +99.6% |
| Tennessee | $526 | $1,453 | 168 | 7,410 | +92.9% |
| Massachusetts | $468 | $1,041 | 127 | 3,900 | +71.5% |
| New York | $422 | $864 | 594 | 23,096 | +54.7% |
| Montana | $417 | $797 | 17 | 475 | +52.9% |
| Georgia | $398 | $1,151 | 189 | 4,238 | +46.0% |
| Texas | $398 | $1,074 | 1,127 | 66,791 | +45.8% |
| Colorado | $397 | $919 | 248 | 6,978 | +45.4% |
| Virginia | $356 | $737 | 259 | 8,763 | +30.7% |
| Florida | $335 | $856 | 720 | 66,411 | +22.8% |
| Maine | $320 | $600 | 42 | 909 | +17.4% |
| New Jersey | $308 | $636 | 355 | 17,111 | +12.7% |
| Kansas | $299 | $640 | 103 | 3,060 | +9.8% |
| Indiana | $282 | $466 | 179 | 3,917 | +3.3% |
| Illinois | $265 | $547 | 544 | 16,576 | -2.9% |
| Mississippi | $248 | $451 | 67 | 2,627 | -9.0% |
| Rhode Island | $220 | $583 | 16 | 338 | -19.2% |
| California | $211 | $467 | 1,163 | 108,922 | -22.8% |
| Kentucky | $209 | $295 | 89 | 3,684 | -23.4% |
| New Mexico | $208 | $299 | 68 | 2,823 | -23.9% |
| Nebraska | $204 | $276 | 95 | 2,912 | -25.4% |
| Missouri | $201 | $428 | 220 | 7,911 | -26.2% |
| North Dakota | $170 | $210 | 20 | 655 | -37.6% |
| Michigan | $166 | $208 | 204 | 4,851 | -39.3% |
| Oklahoma | $138 | $313 | 91 | 7,548 | -49.5% |
| Nevada | $130 | $334 | 136 | 6,993 | -52.5% |
| Iowa | $128 | $173 | 86 | 2,350 | -53.0% |
| Arizona | $122 | $359 | 348 | 23,126 | -55.3% |
| Arkansas | $101 | $226 | 114 | 9,646 | -62.8% |
| Pennsylvania | $99 | $242 | 318 | 42,500 | -63.7% |
| New Hampshire | $83 | $106 | 45 | 373 | -69.6% |
| Minnesota | $82 | $198 | 278 | 7,997 | -70.1% |
| Wisconsin | $71 | $137 | 121 | 10,380 | -74.0% |
| Washington | $62 | $123 | 245 | 72,112 | -77.2% |
| Puerto Rico | $62 | $72 | 21 | 301 | -77.3% |
| Hawaii | $49 | $110 | 26 | 2,236 | -81.9% |
| Alabama | $37 | $80 | 151 | 4,522 | -86.4% |
| Wyoming | $27 | $126 | 15 | 495 | -90.2% |
| Alaska | $27 | $105 | 41 | 1,966 | -90.2% |
| Vermont | $8 | $25 | 6 | 882 | -97.0% |
⚠️ 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