Virginia · 96417

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

Virginia Medicare Avg
$51.18
1% above national avg
National Medicare Avg
$50.77
All states combined
Billed Charge (VA)
$321.27
What providers submit
Est. Commercial (VA)
$141.82
National avg: $137.32
Est. Cash / Self-Pay (VA)
$136.70
Typical self-pay discount

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

14.5K
Services in VA
179
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Virginia

Provider Medicare Services
Caffey, Soren MD $60.90 392
West, Randal M.D. $50.26 299
Zhang, Yue MD $50.08 296
Alberico, Thomas MD $49.13 265
Merten, Suzan M.D. $49.73 237
Nandagopal, Lakshminarayanan $49.48 223

Virginia Pricing in Context

In Virginia, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $51.18 — 1% above the national benchmark of $50.77. 179 providers across the state submitted claims for this procedure in 2023, performing 14.5K total services. Individual payments in VA 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 Virginia is $321.27, 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 Virginia 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 Virginia lands near $141.82, with self-pay cash prices typically around $136.70. 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 Virginia?

The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Virginia is $51.18, which is 1% above the national average of $50.77. Providers in VA typically bill $321.27 for this procedure.

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

With commercial insurance in Virginia, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $141.82. Without insurance, the estimated cash price is $136.70. 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 Virginia?

179 providers in Virginia billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 14.5K 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 Virginia than the national average?

No — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 1% above the national average in Virginia. The state average Medicare payment is $51.18 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