J9999

Not otherwise classified, antineoplastic drugs

Medicare pricing data for 704 providers across 17 states

🤖AI Overview

Prices vary significantly by location — from $0 in New Mexico to $31,591 in Missouri. 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

Not otherwise classified, antineoplastic drugs (HCPCS code J9999) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $781.27, but hospitals typically charge $2,434 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$156.25

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $781.27, your out-of-pocket cost would be approximately $156.25. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$781.27
Average Hospital Charge
$2,434
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$2,434.13
Medicare Allowed$781.27
Medicare Payment$622.47

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $622.47 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Missouri$31,591$64,8171318+3943.6%
Minnesota$8,830$24,63954308+1030.3%
Colorado$8,604$27,76215100+1001.3%
Tennessee$7,779$23,35734198+895.6%
Illinois$5,379$18,23147333+588.5%
Arizona$4,543$19,43530120+481.5%
North Carolina$2,407$10,2241577+208.1%
Texas$2,344$8,41354504+200.0%
Florida$1,487$4,4061561,838+90.4%
Washington$896$2,06511353+14.7%
California$508$1,776774,716-35.0%
Kansas$500$3,14410557-36.0%
Oregon$217$1,01118155-72.2%
Ohio$178$536113,423-77.2%
Maryland$141$29271,966-81.9%
Puerto Rico$57$65623-92.7%
New Mexico$0$561255-99.9%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber