Q2028

Injection, sculptra, 0.5 mg

Medicare pricing data for 31 providers across 4 states

🤖AI Overview

Prices vary significantly by location — from $0 in Rhode Island to $1 in California. 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

Injection, sculptra, 0.5 mg (HCPCS code Q2028) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1.10, but hospitals typically charge $3.71 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.22

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1.10, your out-of-pocket cost would be approximately $0.22. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1.10
Average Hospital Charge
$3.71
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$3.71
Medicare Allowed$1.10
Medicare Payment$0.87

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $0.87 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$1$418442,353+10.0%
New York$1$2236,015-46.4%
Massachusetts$1$1222,785-49.1%
Rhode Island$0$2125,725-57.3%

⚠️ 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