95115

Professional service for single injection of allergen

Medicare pricing data for 9,874 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

Professional service for single injection of allergen (HCPCS code 95115) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $9.41, but hospitals typically charge $26.13 — a 2.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.88

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $9.41, your out-of-pocket cost would be approximately $1.88. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$9.41
Average Hospital Charge
$26.13
Markup Ratio
2.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$26.13
Medicare Allowed$9.41
Medicare Payment$6.66

Hospitals charge 2.8x more than what Medicare allows for this procedure. Medicare actually pays $6.66 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$12$3012677+29.9%
California$12$3041633,812+22.5%
New Jersey$11$301805,648+19.6%
Hawaii$11$3513529+16.2%
Maryland$11$3418519,068+15.4%
Alaska$11$3624831+15.3%
New York$11$3740611,024+15.2%
Connecticut$11$37773,220+13.4%
Washington$10$2820910,364+11.4%
Massachusetts$10$331698,788+11.2%
Rhode Island$10$26181,290+10.7%
New Hampshire$10$31272,071+10.2%
Virginia$10$2637026,391+8.3%
Colorado$10$2616913,342+8.0%
Delaware$10$22333,097+7.2%
Puerto Rico$10$106340+5.6%
Illinois$10$292129,774+5.3%
Minnesota$10$361772,009+4.6%
Wyoming$10$29602,704+3.9%
Florida$10$2449643,794+3.1%
Pennsylvania$10$2543020,644+3.1%
North Dakota$10$4028266+3.0%
Oregon$10$28886,851+2.7%
Nevada$10$43381,941+2.6%
Maine$10$2410290+2.0%
Montana$10$22351,839+1.2%
Texas$10$2588498,086+1.0%
Arizona$9$2222320,619+0.9%
Michigan$9$2527723,9910.0%
Wisconsin$9$491244,150-1.0%
South Dakota$9$22451,856-1.3%
North Carolina$9$2641838,498-3.2%
Utah$9$231336,349-3.5%
Georgia$9$3031617,421-3.8%
South Carolina$9$2622729,464-4.3%
New Mexico$9$28686,657-4.6%
Ohio$9$2535325,756-4.6%
Iowa$9$311168,009-5.5%
Kansas$9$251545,931-5.7%
Louisiana$9$2613214,329-6.4%
Missouri$9$2723422,999-6.7%
Idaho$9$24434,512-7.0%
Indiana$9$2526211,731-7.0%
Nebraska$9$241676,361-7.0%
Oklahoma$9$2116615,004-7.1%
West Virginia$9$25606,176-7.9%
Alabama$9$1917715,480-8.7%
Kentucky$9$2342522,564-9.2%
Tennessee$8$2547539,483-10.7%
Mississippi$8$2819315,170-12.0%
Arkansas$8$2329929,401-12.1%
Vermont$8$2811123-19.0%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber