64612

Injection of chemical for paralysis of nerve muscles on side of face

Medicare pricing data for 5,780 providers across 52 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

Injection of chemical for paralysis of nerve muscles on side of face (HCPCS code 64612) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $165.75, but hospitals typically charge $620.98 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$33.15

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $165.75, your out-of-pocket cost would be approximately $33.15. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$165.75
Average Hospital Charge
$620.98
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$620.98
Medicare Allowed$165.75
Medicare Payment$123.45

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $123.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$196$59823392+18.2%
New Jersey$186$7031441,801+12.5%
New York$186$9113384,553+12.2%
California$183$5916769,674+10.3%
Colorado$179$8201331,460+7.8%
Massachusetts$178$8991712,643+7.7%
Connecticut$177$69562702+7.0%
Virginia$171$4941332,138+3.2%
Maryland$171$5511141,770+3.1%
Minnesota$169$8591311,362+2.2%
Illinois$169$6792172,526+1.9%
Rhode Island$169$53410252+1.9%
Texas$167$6083905,086+0.8%
Hawaii$167$39533471+0.8%
Washington$167$4681431,845+0.7%
Florida$167$5244236,215+0.6%
Delaware$165$51520228-0.7%
North Carolina$164$6061652,926-1.2%
Michigan$163$6181661,829-1.6%
Georgia$162$6691431,937-2.3%
Utah$162$58751607-2.4%
Arizona$161$4671191,978-3.1%
Alaska$160$1,246930-3.3%
Pennsylvania$160$5102503,449-3.5%
Oregon$159$49788835-4.0%
Nevada$159$64042471-4.3%
South Carolina$156$6021081,541-5.9%
Missouri$156$6011091,336-5.9%
Alabama$156$458731,115-6.0%
New Mexico$155$40827393-6.6%
New Hampshire$155$48329290-6.6%
Wyoming$155$488939-6.7%
Maine$154$33218250-7.0%
Montana$154$31426266-7.0%
North Dakota$154$39526209-7.2%
Indiana$154$4701131,390-7.2%
Kentucky$154$55757697-7.2%
Louisiana$152$55278964-8.1%
West Virginia$151$52132251-8.7%
South Dakota$151$36328303-9.1%
Oklahoma$150$43850964-9.2%
Tennessee$150$6591421,908-9.8%
Kansas$149$48752902-10.0%
Mississippi$147$58641689-11.0%
Nebraska$147$55242544-11.3%
Puerto Rico$146$15410139-11.6%
Idaho$146$43836294-12.1%
Wisconsin$144$1,5261251,247-12.9%
Iowa$144$62765960-13.3%
Arkansas$143$41343682-13.7%
Ohio$137$6222003,226-17.2%
Vermont$135$3146172-18.3%

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

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