98942

Chiropractic manipulative treatment, 5 spinal regions

Medicare pricing data for 6,701 providers across 51 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

Chiropractic manipulative treatment, 5 spinal regions (HCPCS code 98942) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $51.07, but hospitals typically charge $72.25 — a 1.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.21

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $51.07, your out-of-pocket cost would be approximately $10.21. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$51.07
Average Hospital Charge
$72.25
Markup Ratio
1.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$72.25
Medicare Allowed$51.07
Medicare Payment$37.12

Hospitals charge 1.4x more than what Medicare allows for this procedure. Medicare actually pays $37.12 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$68$115303,295+32.6%
California$55$80600159,530+7.5%
New Jersey$54$7543878,207+6.5%
Massachusetts$53$7814915,870+4.4%
Maryland$52$657413,091+2.7%
New York$52$6512818,326+2.0%
Montana$52$77444,051+1.2%
Washington$52$7925826,999+1.0%
Colorado$51$67749,280+0.5%
Delaware$51$87465,690+0.4%
Rhode Island$51$74152,865+0.2%
North Dakota$51$987429-0.3%
Wyoming$51$8914775-0.5%
Hawaii$51$74173,137-0.6%
Nevada$51$73305,095-0.8%
South Dakota$51$68793,168-1.1%
Vermont$51$65425,512-1.1%
Virginia$50$6414232,151-1.3%
Pennsylvania$50$6733041,651-1.6%
Puerto Rico$50$52905,133-1.7%
Arizona$50$7715233,376-1.9%
Florida$50$8134245,507-2.0%
New Hampshire$50$62508,443-2.0%
Minnesota$50$66933,581-2.2%
Georgia$50$7514317,725-2.3%
Michigan$50$7174071,464-2.5%
Oregon$50$89814,132-2.8%
Connecticut$49$60223,484-3.2%
Texas$49$7044968,929-3.2%
Utah$49$80537,748-3.3%
Maine$49$70342,845-3.3%
Wisconsin$49$821677,611-3.9%
Ohio$49$7215321,491-4.0%
Illinois$49$6518718,421-4.4%
Iowa$49$611369,719-4.4%
Idaho$49$658111,488-4.5%
Missouri$49$5812312,857-4.5%
Kentucky$49$72281,237-4.7%
South Carolina$49$6313814,701-4.8%
Nebraska$48$67987,095-5.1%
New Mexico$48$704812,964-5.2%
Oklahoma$48$61468,649-5.4%
Kansas$48$6613112,904-5.6%
Arkansas$48$738718,704-5.7%
Tennessee$48$689512,666-6.1%
North Carolina$48$6215313,498-7.0%
Louisiana$47$59381,879-7.1%
Alabama$47$5710518,906-7.8%
Mississippi$47$70241,739-7.9%
West Virginia$47$58203,030-8.1%
Indiana$46$55626,742-9.7%

⚠️ 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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