Q4194

Novachor, per square centimeter

Medicare pricing data for 705 providers across 19 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

Novachor, per square centimeter (HCPCS code Q4194) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $1,008, but hospitals typically charge $1,718 — a 1.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$201.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $1,008, your out-of-pocket cost would be approximately $201.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$1,008
Average Hospital Charge
$1,718
Markup Ratio
1.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,718.39
Medicare Allowed$1,007.98
Medicare Payment$802.95

Hospitals charge 1.7x more than what Medicare allows for this procedure. Medicare actually pays $802.95 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Nebraska$1,139$3,8193398+13.0%
Oklahoma$1,013$1,7744710,008+0.5%
Delaware$1,013$1,7448607+0.5%
South Carolina$1,013$1,503334,237+0.5%
Alabama$1,012$1,771248,122+0.4%
West Virginia$1,011$2,127142,855+0.3%
Florida$1,010$1,58715816,853+0.2%
Texas$1,010$1,790739,952+0.2%
Louisiana$1,009$1,694242,058+0.1%
North Carolina$1,008$1,406262,599-0.0%
Pennsylvania$1,007$1,479713,974-0.1%
Mississippi$1,005$1,31410917-0.3%
Georgia$1,001$2,128485,825-0.7%
Arkansas$1,000$1,26014836-0.8%
Ohio$1,000$1,21631,221-0.8%
Tennessee$999$2,197261,693-0.8%
Virginia$993$1,25517787-1.5%
Maryland$987$1,587282,010-2.1%
New Jersey$984$1,591391,562-2.4%

⚠️ 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