95816

Measurement of brain wave activity (eeg), awake and drowsy

Medicare pricing data for 8,022 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $53 in Idaho to $345 in California. 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

Measurement of brain wave activity (eeg), awake and drowsy (HCPCS code 95816) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $213.53, but hospitals typically charge $485.77 — a 2.3x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$42.71

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $213.53, your out-of-pocket cost would be approximately $42.71. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$213.53
Average Hospital Charge
$485.77
Markup Ratio
2.3x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$485.77
Medicare Allowed$213.53
Medicare Payment$168.07

Hospitals charge 2.3x more than what Medicare allows for this procedure. Medicare actually pays $168.07 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$345$55769665,760+61.5%
Puerto Rico$313$33537286+46.5%
New York$280$61360726,098+31.0%
Wyoming$273$6698176+27.9%
Arizona$236$5521906,669+10.7%
Texas$212$57278218,469-0.8%
Virginia$209$4281745,804-2.3%
New Jersey$208$5602849,937-2.4%
Missouri$205$3841558,630-3.9%
Michigan$199$4902626,893-6.9%
District of Columbia$196$40128951-8.4%
New Mexico$193$35520368-9.6%
Arkansas$187$613582,085-12.6%
Hawaii$183$40921410-14.3%
Nevada$182$4101036,808-14.8%
Rhode Island$181$484361,286-15.1%
North Carolina$180$4982325,365-15.6%
Florida$180$54975120,881-15.6%
West Virginia$176$386331,344-17.6%
Alaska$169$77923149-20.8%
Louisiana$148$4741253,196-30.9%
Oklahoma$141$319692,029-33.8%
Utah$141$38932612-34.0%
South Carolina$139$4521284,545-34.7%
Georgia$137$4332415,488-35.9%
Alabama$135$3011362,965-37.0%
Ohio$132$3072729,401-38.2%
Mississippi$131$349632,020-38.7%
Maryland$127$3041425,357-40.5%
Tennessee$125$3432024,869-41.6%
Indiana$125$2712165,636-41.7%
Minnesota$118$5121431,873-44.8%
Colorado$110$629931,518-48.4%
Massachusetts$107$4041605,206-50.1%
Oregon$100$30858803-53.1%
North Dakota$97$44724485-54.7%
Illinois$95$3882946,940-55.3%
Wisconsin$92$5831461,887-57.0%
Connecticut$90$614852,426-57.9%
Washington$86$2661222,192-59.9%
Maine$82$33641443-61.7%
Delaware$81$37335893-62.2%
Vermont$78$46517295-63.5%
Pennsylvania$77$3453059,107-63.8%
Kentucky$77$202943,118-63.9%
Nebraska$77$28938665-64.0%
New Hampshire$74$474551,052-65.1%
Kansas$73$329591,090-65.8%
Iowa$62$40343803-71.0%
Montana$57$16224215-73.1%
South Dakota$54$12631692-74.5%
Idaho$53$13322407-75.3%

⚠️ 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