95870

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study

Medicare pricing data for 689 providers across 38 states

🤖AI Overview

This procedure has a 43.2x markup — hospitals charge $876.87 but Medicare allows only $20.30. Uninsured patients may face bills 43.2 times higher than what insurance negotiates. Prices vary significantly by location — from $18 in Kansas to $80 in Missouri. 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

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study (HCPCS code 95870) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $20.30, but hospitals typically charge $876.87 — a 43.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.06

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $20.30, your out-of-pocket cost would be approximately $4.06. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$20.30
Average Hospital Charge
$876.87
Markup Ratio
43.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$876.87
Medicare Allowed$20.30
Medicare Payment$16.05

Hospitals charge 43.2x more than what Medicare allows for this procedure. Medicare actually pays $16.05 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Missouri$80$267817+291.7%
Alaska$26$742170+25.7%
Florida$23$740363,337+10.9%
Pennsylvania$22$1,217332,131+10.0%
New York$22$1,106452,948+9.5%
Nevada$21$5418844+4.5%
District of Columbia$21$5042288+4.0%
California$21$581725,777+2.3%
Texas$21$1,509737,450+1.9%
Massachusetts$21$314101,039+1.6%
Washington$21$1,036171,224+1.3%
Minnesota$20$345341,040+0.1%
Illinois$20$797371,574-0.1%
New Jersey$20$1,216161,299-0.9%
Connecticut$20$1,00531,071-1.4%
Tennessee$20$6998754-1.9%
Michigan$20$488251,057-2.7%
Hawaii$20$3771359-3.2%
Oregon$20$895174-3.2%
Maryland$20$358252,057-3.3%
Colorado$19$1,052195,169-4.5%
Delaware$19$377134-6.0%
Utah$19$3,14413626-6.6%
Virginia$19$77571,347-6.6%
Georgia$19$1,299101,046-6.7%
Arizona$19$1,070161,970-6.9%
Nebraska$18$1822130-9.1%
Ohio$18$653181,608-9.2%
North Carolina$18$420121,833-9.4%
Louisiana$18$94131,605-9.5%
New Mexico$18$3771254-9.8%
South Carolina$18$3722384-9.9%
Oklahoma$18$5863471-10.0%
Wisconsin$18$5489812-10.0%
Indiana$18$75426-10.6%
Arkansas$18$1,331474-10.6%
Iowa$18$169564-10.8%
Kansas$18$30971,478-10.9%

⚠️ 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

💊 Need post-procedure medications? Check costs on OpenPrescriber