94660

Therapy procedure using a positive pressure ventilator

Medicare pricing data for 825 providers across 38 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

Therapy procedure using a positive pressure ventilator (HCPCS code 94660) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $61.82, but hospitals typically charge $156.75 — a 2.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$12.36

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $61.82, your out-of-pocket cost would be approximately $12.36. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$61.82
Average Hospital Charge
$156.75
Markup Ratio
2.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$156.75
Medicare Allowed$61.82
Medicare Payment$45.89

Hospitals charge 2.5x more than what Medicare allows for this procedure. Medicare actually pays $45.89 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$73$197894,109+17.6%
New York$72$24128765+16.1%
Washington$71$2308526+15.1%
New Jersey$69$14422924+11.4%
Hawaii$68$210112+10.6%
Connecticut$67$19719592+8.4%
Maryland$67$16112237+8.2%
Virginia$66$16123506+6.6%
Massachusetts$64$149448+3.3%
Delaware$64$80121+2.9%
Puerto Rico$63$653421+1.8%
Colorado$63$12249816+1.8%
Florida$61$124764,960-0.7%
Michigan$61$12721252-1.0%
Missouri$61$1188977-1.6%
Texas$60$128833,147-2.7%
Georgia$60$161691,024-3.0%
Nevada$60$1321140-3.1%
Utah$60$1141483-3.4%
Ohio$59$9729421-4.2%
South Carolina$59$173151,317-4.5%
Illinois$59$13435560-4.6%
Kansas$59$188716-5.2%
Pennsylvania$58$12525145-6.5%
Louisiana$58$90579-6.8%
Kentucky$57$2937216-8.0%
Arkansas$57$139232-8.5%
Arizona$56$209381,411-9.2%
North Carolina$56$15426838-9.3%
New Mexico$55$10411313-10.5%
Indiana$54$10312262-12.0%
Oregon$53$21310104-13.5%
Mississippi$53$125342-13.8%
Oklahoma$50$904198-18.5%
Alabama$50$15819400-18.7%
Tennessee$49$14317358-20.5%
Minnesota$47$183529-23.3%
Wisconsin$37$2467817-40.9%

⚠️ 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

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