Idaho · 96417

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

Idaho Medicare Avg
$46.05
9% below national avg
National Medicare Avg
$50.77
All states combined
Billed Charge (ID)
$186.20
What providers submit
Est. Commercial (ID)
$121.26
National avg: $137.32
Est. Cash / Self-Pay (ID)
$94.51
Typical self-pay discount

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

764
Services in ID
9
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Idaho

Provider Medicare Services
Martincic, Danko MD $45.59 305
Bartels, David DO $46.56 269

Idaho Pricing in Context

In Idaho, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $46.05 — 9% below the national benchmark of $50.77. 9 providers across the state submitted claims for this procedure in 2023, performing 764 total services. Individual payments in ID 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 Idaho is $186.20, 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 Idaho 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 Idaho lands near $121.26, with self-pay cash prices typically around $94.51. 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 Idaho?

The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Idaho is $46.05, which is 9% below the national average of $50.77. Providers in ID typically bill $186.20 for this procedure.

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

With commercial insurance in Idaho, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $121.26. Without insurance, the estimated cash price is $94.51. 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 Idaho?

9 providers in Idaho billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 764 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 Idaho than the national average?

Yes — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 9% below the national average in Idaho. The state average Medicare payment is $46.05 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