J1050

Injection, medroxyprogesterone acetate, 1 mg

Medicare pricing data for 2,832 providers across 40 states

🤖AI Overview

This procedure has a 5.5x markup — hospitals charge $1.32 but Medicare allows only $0.24. Uninsured patients may face bills 5.5 times higher than what insurance negotiates. Prices vary significantly by location — from $0 in Colorado to $2 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

Injection, medroxyprogesterone acetate, 1 mg (HCPCS code J1050) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $0.24, but hospitals typically charge $1.32 — a 5.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.05

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $0.24, your out-of-pocket cost would be approximately $0.05. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$0.24
Average Hospital Charge
$1.32
Markup Ratio
5.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1.32
Medicare Allowed$0.24
Medicare Payment$0.17

Hospitals charge 5.5x more than what Medicare allows for this procedure. Medicare actually pays $0.17 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$2$310120,296+662.5%
Oregon$1$1226,000+337.5%
North Dakota$1$1113,750+291.7%
Utah$1$1193,977+266.7%
Montana$1$1113,150+250.0%
South Dakota$1$2185,852+250.0%
Washington$1$1407,545+237.5%
Indiana$1$17516,352+212.5%
Kansas$1$1307,501+175.0%
Iowa$1$110331,351+158.3%
Michigan$1$16614,449+145.8%
Missouri$1$1358,853+125.0%
Nebraska$1$17021,001+125.0%
Ohio$0$116641,973+100.0%
Arizona$0$1256,290+91.7%
Kentucky$0$16413,294+66.7%
South Carolina$0$2399,232+25.0%
Georgia$0$14010,526+20.8%
Alabama$0$3238,563+8.3%
North Carolina$0$16611,574+4.2%
Tennessee$0$14723,966+4.2%
Illinois$0$16419,201-20.8%
Massachusetts$0$2143,301-20.8%
Minnesota$0$110727,160-20.8%
Wisconsin$0$19327,600-20.8%
New York$0$2214,503-33.3%
Virginia$0$15117,482-50.0%
Mississippi$0$26627,669-87.5%
Florida$0$15410,542-91.7%
Louisiana$0$15114,879-91.7%
Delaware$0$10111,654-95.8%
District of Columbia$0$1183,761-95.8%
Maryland$0$16516,564-95.8%
New Jersey$0$25716,047-95.8%
New Mexico$0$15118,006-95.8%
Oklahoma$0$212935,474-95.8%
Pennsylvania$0$120659,197-95.8%
Texas$0$1322111,758-95.8%
Arkansas$0$112469,021-95.8%
Colorado$0$120557,877-95.8%

⚠️ 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