95117

Professional service for multiple injections of allergen

Medicare pricing data for 13,765 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 2.4 million services annually. Even small pricing inefficiencies here affect millions of patients. 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 multiple injections of allergen (HCPCS code 95117) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.28, but hospitals typically charge $35.07 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$2.26

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.28, your out-of-pocket cost would be approximately $2.26. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$11.28
Average Hospital Charge
$35.07
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$35.07
Medicare Allowed$11.28
Medicare Payment$8.10

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $8.10 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$14$48125,212+24.8%
California$13$41547193,184+19.1%
New Jersey$13$3629754,584+17.6%
New York$13$4971899,628+16.8%
Maryland$13$3626235,367+12.6%
Connecticut$13$4511915,320+11.9%
Alaska$12$42231,491+10.5%
Massachusetts$12$4724844,746+9.5%
Washington$12$3726124,620+7.8%
Hawaii$12$4817523+7.6%
Rhode Island$12$35277,016+6.7%
New Hampshire$12$44324,831+5.6%
Illinois$12$3730342,485+5.5%
Colorado$12$3219625,694+4.9%
Delaware$12$285018,968+3.7%
Puerto Rico$12$137253+3.1%
Virginia$12$31571122,605+3.0%
Minnesota$12$432897,476+2.4%
Nevada$11$395119,954+1.2%
Pennsylvania$11$3072797,637+1.0%
Vermont$11$3414820+1.0%
Maine$11$27221,503+0.9%
North Dakota$11$4238652+0.5%
Florida$11$30767174,426+0.4%
Michigan$11$3036652,870+0.4%
Oregon$11$5112612,397+0.4%
Texas$11$341,123245,387-1.3%
Wyoming$11$40723,446-1.3%
Montana$11$31502,895-1.6%
Arizona$11$30386113,142-1.8%
Wisconsin$11$581356,979-2.1%
South Dakota$11$29561,390-3.5%
Utah$11$281199,029-5.8%
North Carolina$11$35540100,051-6.2%
South Carolina$11$3932095,563-6.5%
Missouri$11$3722240,890-6.6%
Ohio$11$3342669,428-6.6%
Georgia$11$4345469,278-6.9%
New Mexico$10$3011230,660-7.4%
Indiana$10$3442748,193-7.9%
Louisiana$10$3514829,419-8.6%
Idaho$10$31586,790-8.7%
Iowa$10$3219514,947-9.6%
West Virginia$10$3210815,909-10.0%
Kansas$10$2924729,002-10.2%
Kentucky$10$33593104,831-10.2%
Nebraska$10$331798,702-10.3%
Oklahoma$10$2828136,083-10.4%
Tennessee$10$34788149,977-12.0%
Alabama$10$2419127,958-12.5%
Arkansas$10$3225025,166-12.9%
Mississippi$10$3719316,884-14.6%

⚠️ 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

🏥 See Medicare hospital data on OpenMedicare