96921

Treatment of inflammatory skin disease using laser, 250.0-500.0 sq cm

Medicare pricing data for 1,091 providers across 25 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

Treatment of inflammatory skin disease using laser, 250.0-500.0 sq cm (HCPCS code 96921) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $177.58, but hospitals typically charge $386.41 — a 2.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$35.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $177.58, your out-of-pocket cost would be approximately $35.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$177.58
Average Hospital Charge
$386.41
Markup Ratio
2.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$386.41
Medicare Allowed$177.58
Medicare Payment$139.30

Hospitals charge 2.2x more than what Medicare allows for this procedure. Medicare actually pays $139.30 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$196$4661062,887+10.5%
California$193$3921514,768+8.4%
New Jersey$188$46256886+5.9%
Maryland$185$305231,208+4.4%
Virginia$181$44325462+2.0%
Pennsylvania$178$241381,087-0.0%
Washington$172$33715348-3.2%
Massachusetts$170$55143465-4.3%
Minnesota$169$452341,104-4.8%
Wisconsin$169$47713320-4.9%
Michigan$167$32626422-6.1%
Texas$167$356601,089-6.1%
Illinois$166$43051648-6.3%
Florida$165$3141252,216-7.2%
Oregon$165$3971443-7.3%
North Dakota$163$4738331-8.5%
Arizona$163$36227459-8.5%
Georgia$162$45034330-8.6%
New Hampshire$162$6191882-9.0%
Indiana$158$54913221-10.9%
Ohio$157$28817127-11.5%
North Carolina$156$34026259-11.9%
Tennessee$150$30350645-15.5%
South Carolina$148$3319168-16.7%
Mississippi$145$2129145-18.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber