Q4249

Amniply, for topical use only, per square centimeter

Medicare pricing data for 50 providers across 5 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

Amniply, for topical use only, per square centimeter (HCPCS code Q4249) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $604.11, but hospitals typically charge $711.45 — a 1.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$120.82

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $604.11, your out-of-pocket cost would be approximately $120.82. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$604.11
Average Hospital Charge
$711.45
Markup Ratio
1.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$711.45
Medicare Allowed$604.11
Medicare Payment$481.30

Hospitals charge 1.2x more than what Medicare allows for this procedure. Medicare actually pays $481.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$647$8001233+7.0%
Arkansas$645$72563,534+6.7%
Texas$633$742257,271+4.8%
Kentucky$575$70029,974-4.9%
California$573$6252997-5.2%

⚠️ 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