Hawaii · 96417

Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Hawaii

Hawaii Medicare Avg
$54.94
8% above national avg
National Medicare Avg
$50.77
All states combined
Billed Charge (HI)
$132.91
What providers submit
Est. Commercial (HI)
$168.68
National avg: $137.32
Est. Cash / Self-Pay (HI)
$88.19
Typical self-pay discount

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

110
Services in HI
7
Providers
N/A
Min Payment
N/A
Max Payment

Hawaii Pricing in Context

In Hawaii, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $54.94 — 8% above the national benchmark of $50.77. 7 providers across the state submitted claims for this procedure in 2023, performing 110 total services. Individual payments in HI 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 Hawaii is $132.91, 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 Hawaii sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Hawaii lands near $168.68, with self-pay cash prices typically around $88.19. 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 Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost in Hawaii?

The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Hawaii is $54.94, which is 8% above the national average of $50.77. Providers in HI typically bill $132.91 for this procedure.

What does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost with insurance in Hawaii?

With commercial insurance in Hawaii, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $168.68. Without insurance, the estimated cash price is $88.19. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Hawaii?

7 providers in Hawaii billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 110 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cheaper in Hawaii than the national average?

No — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 8% above the national average in Hawaii. The state average Medicare payment is $54.94 compared to $50.77 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