96411

Administration of additional new drug or substance into vein using push technique

Medicare pricing data for 4,643 providers across 50 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

Administration of additional new drug or substance into vein using push technique (HCPCS code 96411) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $54.75, but hospitals typically charge $217.14 — a 4.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.95

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $54.75, your out-of-pocket cost would be approximately $10.95. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$54.75
Average Hospital Charge
$217.14
Markup Ratio
4.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$217.14
Medicare Allowed$54.75
Medicare Payment$43.39

Hospitals charge 4.0x more than what Medicare allows for this procedure. Medicare actually pays $43.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$64$23651811,027+17.8%
District of Columbia$64$1751189+16.7%
New Jersey$62$2261363,884+13.7%
Maryland$62$2111253,912+12.6%
Hawaii$61$111658+12.1%
New York$60$2072314,928+10.4%
Connecticut$60$22530546+9.7%
Alaska$60$33518638+8.8%
Massachusetts$58$23427461+6.2%
Washington$57$192961,645+4.6%
Colorado$57$278651,702+3.8%
New Hampshire$56$24315276+3.2%
Vermont$56$1853235+3.1%
Delaware$56$26513423+2.4%
Virginia$56$2691624,545+2.3%
Pennsylvania$56$2081433,372+1.9%
Wyoming$56$254661+1.6%
Puerto Rico$55$621154+0.6%
Illinois$55$2652496,539-0.0%
Minnesota$55$2681522,064-0.0%
Nevada$55$239641,669-0.2%
Oregon$54$228621,072-1.0%
Florida$53$17945814,819-2.3%
Missouri$53$2081122,361-2.5%
Maine$53$23519444-2.7%
North Dakota$53$1666136-3.1%
Arizona$53$2211664,861-3.1%
Texas$53$26152811,557-3.2%
Michigan$53$139912,106-3.3%
New Mexico$52$22028710-5.2%
South Dakota$52$2077167-5.7%
Wisconsin$51$39349574-6.6%
Utah$51$15129442-6.9%
North Carolina$51$177861,435-7.2%
Ohio$51$2141292,800-7.8%
Georgia$50$219862,432-7.8%
South Carolina$50$203642,107-8.0%
Nebraska$50$135481,530-8.5%
Idaho$50$1617164-8.8%
Iowa$50$161471,685-9.0%
Indiana$50$219661,568-9.2%
Kansas$50$187522,010-9.2%
Oklahoma$50$14226710-9.6%
West Virginia$49$1253236-9.9%
Tennessee$49$1571573,896-10.8%
Kentucky$49$14616341-11.0%
Alabama$48$2231002,497-11.6%
Louisiana$48$20437926-12.3%
Arkansas$47$183482,700-13.4%
Mississippi$46$205261,635-15.1%

⚠️ 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