Q4038

Cast supplies, short leg cast, adult (11 years +), fiberglass

Medicare pricing data for 6,233 providers across 50 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

Cast supplies, short leg cast, adult (11 years +), fiberglass (HCPCS code Q4038) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $46.71, but hospitals typically charge $111.47 — a 2.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$9.34

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $46.71, your out-of-pocket cost would be approximately $9.34. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$46.71
Average Hospital Charge
$111.47
Markup Ratio
2.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$111.47
Medicare Allowed$46.71
Medicare Payment$36.36

Hospitals charge 2.4x more than what Medicare allows for this procedure. Medicare actually pays $36.36 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maine$48$1351146+3.2%
Montana$48$8628108+3.2%
North Dakota$48$103525+3.2%
Massachusetts$48$118104582+2.8%
Louisiana$48$9498842+2.6%
New Jersey$48$1101411,924+2.5%
South Dakota$48$1022191+2.5%
Delaware$48$1391467+2.4%
Kansas$48$7774470+2.3%
Virginia$48$891801,171+2.3%
Minnesota$48$137101360+2.1%
Puerto Rico$48$73614+2.0%
Maryland$48$139124927+2.0%
Arizona$47$1361441,536+1.6%
Illinois$47$1422351,464+1.5%
Colorado$47$1351411,144+1.4%
Pennsylvania$47$971821,227+1.3%
Florida$47$1283542,253+1.3%
North Carolina$47$1152781,491+1.2%
West Virginia$47$10919117+1.1%
Mississippi$47$1181131,043+1.0%
Alaska$47$723187+1.0%
Ohio$47$902241,344+0.9%
Rhode Island$47$11715123+0.9%
Tennessee$47$1002441,667+0.6%
Wisconsin$47$125125518+0.3%
Washington$47$1451441,203+0.3%
California$47$1075964,521+0.2%
Connecticut$47$11881471+0.1%
Hawaii$47$140853-0.4%
Oklahoma$47$8786941-0.4%
Arkansas$46$9538420-0.7%
Texas$46$1163963,490-0.7%
Idaho$46$1022597-0.8%
Wyoming$46$8219172-0.9%
Iowa$46$85102590-0.9%
Nebraska$46$10439184-1.0%
Georgia$46$1702231,250-1.0%
Kentucky$46$105128719-1.0%
Missouri$46$228109923-1.0%
Michigan$46$742221,308-1.7%
Nevada$46$10257239-2.0%
Alabama$46$5995821-2.3%
Oregon$45$90119889-2.6%
Indiana$45$85170867-3.2%
New Hampshire$45$7062502-4.2%
New York$45$792641,137-4.3%
Utah$44$8966368-5.6%
New Mexico$44$7946254-6.8%
South Carolina$43$78110790-7.2%

⚠️ 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