Q4046

Cast supplies, short leg splint, adult (11 years +), fiberglass

Medicare pricing data for 3,337 providers across 46 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Cast supplies, short leg splint, adult (11 years +), fiberglass (HCPCS code Q4046) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $21.35, but hospitals typically charge $55.25 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.27

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $21.35, your out-of-pocket cost would be approximately $4.27. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$21.35
Average Hospital Charge
$55.25
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$55.25
Medicare Allowed$21.35
Medicare Payment$16.45

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $16.45 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Minnesota$22$494872+2.4%
Wisconsin$22$715686+2.4%
Kansas$22$463462+2.3%
West Virginia$22$431619+2.3%
Connecticut$22$533457+2.3%
Massachusetts$22$12255171+2.3%
Wyoming$22$541224+2.3%
Maryland$22$54104241+2.2%
North Carolina$22$63136209+2.2%
Rhode Island$22$601461+2.2%
Illinois$22$71156387+2.1%
South Dakota$22$381359+2.1%
New Jersey$22$4953106+1.9%
New Hampshire$22$603362+1.8%
Louisiana$22$6452134+1.7%
Kentucky$22$4946130+1.5%
Texas$22$43202584+1.4%
Michigan$22$6071152+1.3%
Georgia$22$73111242+1.3%
Iowa$22$463979+1.3%
Ohio$22$6567167+1.0%
Alaska$22$292363+0.9%
Colorado$22$8369142+0.9%
Tennessee$22$58131404+0.8%
Oklahoma$21$5770296+0.4%
Nebraska$21$472255+0.2%
New York$21$4298174+0.2%
Florida$21$51203535+0.1%
Virginia$21$37109244+0.1%
North Dakota$21$47578+0.1%
Mississippi$21$5765205-0.2%
Arizona$21$6180215-0.2%
California$21$54397858-0.2%
Nevada$21$713076-0.3%
Oregon$21$4185158-0.5%
Missouri$21$544570-0.7%
Washington$21$6687142-0.8%
Hawaii$21$911324-1.1%
Alabama$21$3543110-1.2%
Arkansas$21$332762-2.7%
South Carolina$21$4785167-3.7%
Indiana$20$5381168-4.5%
Montana$20$45917-6.7%
Pennsylvania$20$39115239-7.7%
Utah$20$634877-8.7%
New Mexico$19$2628141-10.7%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber