94621

Test for exercise-induced heart and lung stress

Medicare pricing data for 1,694 providers across 47 states

🤖AI Overview

Prices vary significantly by location — from $61 in Wisconsin to $184 in Alaska. 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

Test for exercise-induced heart and lung stress (HCPCS code 94621) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $108.59, but hospitals typically charge $331.91 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.72

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $108.59, your out-of-pocket cost would be approximately $21.72. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$108.59
Average Hospital Charge
$331.91
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$331.91
Medicare Allowed$108.59
Medicare Payment$82.97

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $82.97 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$184$1,347325+69.7%
District of Columbia$153$40923174+40.9%
Maryland$150$39030280+38.3%
New York$143$3691832,510+31.6%
New Jersey$139$38456539+27.9%
Georgia$129$37452818+19.2%
Florida$128$3211702,370+17.4%
Arkansas$126$31411210+15.8%
Alabama$118$25812201+8.7%
Nebraska$110$29324151+1.7%
California$110$2881291,490+1.3%
Tennessee$110$44626372+1.2%
Texas$103$3431151,903-5.4%
Delaware$103$396534-5.6%
South Carolina$99$32824157-8.7%
Illinois$97$40264508-10.6%
Connecticut$95$38232364-12.6%
North Carolina$94$33944420-13.8%
Kentucky$92$19034209-15.2%
Washington$92$21031200-15.2%
Virginia$89$22150391-18.4%
Arizona$86$23432306-20.7%
Pennsylvania$81$22685545-25.6%
Massachusetts$80$332481,251-26.3%
Oklahoma$77$1731475-28.7%
Missouri$75$3182292-31.1%
Michigan$75$23258336-31.3%
Minnesota$73$33425161-32.8%
Louisiana$69$24511119-36.4%
Ohio$69$34065467-36.8%
Rhode Island$68$229116-37.4%
Colorado$68$27018102-37.8%
Nevada$67$279816-38.0%
New Hampshire$67$768726-38.1%
Oregon$67$23914105-38.2%
Hawaii$66$175122-38.9%
Montana$66$170521-38.9%
Maine$66$1521233-39.0%
North Dakota$66$216293-39.5%
Vermont$65$319424-39.8%
Indiana$65$26628145-39.9%
Utah$65$152726-40.2%
Kansas$65$26522117-40.5%
Idaho$64$201564-41.0%
Mississippi$63$225929-41.7%
Iowa$63$5131850-42.3%
Wisconsin$61$83425158-43.6%

⚠️ 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