90966

Home dialysis services per month (20 years or older)

Medicare pricing data for 7,090 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

Home dialysis services per month (20 years or older) (HCPCS code 90966) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $288.19, but hospitals typically charge $650.97 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$57.64

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $288.19, your out-of-pocket cost would be approximately $57.64. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$288.19
Average Hospital Charge
$650.97
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$650.97
Medicare Allowed$288.19
Medicare Payment$226.20

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $226.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$386$1,3997836+33.8%
District of Columbia$318$659341,224+10.2%
New Jersey$310$6452156,210+7.4%
California$309$66372033,000+7.2%
Maryland$308$6211637,633+7.0%
New York$308$70634511,393+6.7%
Connecticut$307$732842,656+6.5%
Massachusetts$302$8131544,669+4.8%
New Hampshire$299$791221,292+3.9%
Illinois$295$68236717,393+2.4%
Oregon$293$726753,152+1.5%
Colorado$292$714803,459+1.5%
Hawaii$292$737431,832+1.4%
Pennsylvania$291$57031011,417+0.8%
Washington$291$6351296,266+0.8%
Montana$290$645211,134+0.6%
Florida$290$60051920,068+0.6%
Vermont$289$1,2443113+0.4%
Delaware$289$629341,696+0.4%
Michigan$289$59022910,403+0.3%
Rhode Island$287$64226612-0.4%
Virginia$287$6511678,677-0.5%
Nevada$286$775612,978-0.9%
New Mexico$285$634422,923-1.0%
North Dakota$284$80825945-1.6%
Minnesota$283$837993,463-1.8%
Louisiana$281$5721124,735-2.6%
Texas$281$68264326,707-2.6%
North Carolina$280$66323711,284-3.0%
Puerto Rico$280$28948658-3.0%
Maine$279$60320822-3.1%
Georgia$279$64326411,678-3.1%
Ohio$279$5393049,949-3.2%
South Dakota$278$624281,126-3.4%
Indiana$278$5651637,150-3.6%
Missouri$278$6561578,051-3.7%
Utah$277$675482,017-3.8%
South Carolina$277$5741166,243-4.0%
West Virginia$276$564411,469-4.1%
Kentucky$275$521953,705-4.5%
Idaho$275$551282,015-4.6%
Iowa$274$668473,007-4.9%
Kansas$274$610462,960-5.0%
Arizona$274$5981125,721-5.0%
Mississippi$273$702755,035-5.3%
Wisconsin$273$1,063993,941-5.3%
Alabama$273$546954,462-5.4%
Tennessee$271$7361498,264-6.0%
Oklahoma$271$537775,380-6.1%
Nebraska$270$644271,768-6.4%
Wyoming$267$8175173-7.5%
Arkansas$263$492493,335-8.8%

⚠️ 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