Delaware · 94660

Therapy Procedure Using A Positive Pressure Ventilator in Delaware

Delaware Medicare Avg
$42.57
7% below national avg
National Medicare Avg
$45.89
All states combined
Billed Charge (DE)
$80.00
What providers submit
Est. Commercial (DE)
$143.12
National avg: $132.92
Est. Cash / Self-Pay (DE)
$69.71
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

21
Services in DE
1
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Delaware

Provider Medicare Services
Jawahar, David MD $42.57 21

Delaware Pricing in Context

In Delaware, CPT code 94660 (Therapy Procedure Using A Positive Pressure Ventilator) carries an average Medicare payment of $42.57 — 7% below the national benchmark of $45.89. 1 providers across the state submitted claims for this procedure in 2023, performing 21 total services. Individual payments in DE ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Delaware is $80.00, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Delaware sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Delaware lands near $143.12, with self-pay cash prices typically around $69.71. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Therapy Procedure Using A Positive Pressure Ventilator cost in Delaware?

The average Medicare payment for Therapy Procedure Using A Positive Pressure Ventilator in Delaware is $42.57, which is 7% below the national average of $45.89. Providers in DE typically bill $80.00 for this procedure.

What does Therapy Procedure Using A Positive Pressure Ventilator cost with insurance in Delaware?

With commercial insurance in Delaware, Therapy Procedure Using A Positive Pressure Ventilator costs an estimated $143.12. Without insurance, the estimated cash price is $69.71. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Therapy Procedure Using A Positive Pressure Ventilator in Delaware?

1 providers in Delaware billed Medicare for Therapy Procedure Using A Positive Pressure Ventilator in 2023, performing 21 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Therapy Procedure Using A Positive Pressure Ventilator cheaper in Delaware than the national average?

Yes — Therapy Procedure Using A Positive Pressure Ventilator costs 7% below the national average in Delaware. The state average Medicare payment is $42.57 compared to $45.89 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial