Cost analysis for CPT 95004 — Test for allergy using allergenic extract
Average Medicare Payment
$3.07
2023 data
Total Payments (2023)
$23.4M
Services (2023)
7.4M
Price Change (2014–2023)
-37.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $4.92 | $44.8M | 9.0M | — |
| 2015 | $4.90 | $44.2M | 8.9M | -0.4% |
| 2016 | $5.15 | $49.9M | 9.5M | +5.1% |
| 2017 | $5.13 | $50.7M | 9.7M | -0.4% |
| 2018 | $4.05 | $38.2M | 9.3M | -21.1% |
| 2019 | $3.29 | $31.6M | 9.5M | -18.8% |
| 2020 | $3.31 | $22.5M | 6.7M | +0.6% |
| 2021 | $3.25 | $24.4M | 7.4M | -1.8% |
| 2022 | $3.14 | $23.3M | 7.2M | -3.4% |
| 2023 | $3.07 | $23.4M | 7.4M | -2.2% |
The most expensive state pays 1.6x more than the cheapest for this procedure. NY averages $3.91 vs ID at $2.49.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $3.91 | $3.2M | 813.0K | 304 |
| NJ | $3.56 | $1.0M | 284.6K | 141 |
| CA | $3.51 | $3.9M | 1.1M | 319 |
| DC | $3.50 | $22.9K | 6.5K | 5 |
| MD | $3.41 | $569.2K | 166.8K | 93 |
| AK | $3.32 | $44.2K | 13.3K | 10 |
| HI | $3.28 | $58.4K | 17.8K | 6 |
| CT | $3.25 | $127.9K | 39.3K | 34 |
| MA | $3.24 | $433.7K | 134.0K | 93 |
| IL | $3.23 | $543.1K | 168.1K | 132 |
| FL | $3.15 | $2.5M | 796.6K | 335 |
| RI | $3.13 | $39.7K | 12.7K | 6 |
| WY | $3.07 | $12.2K | 4.0K | 4 |
| MI | $3.07 | $433.5K | 141.2K | 87 |
| CO | $3.07 | $293.1K | 95.6K | 52 |
| WA | $3.06 | $221.9K | 72.4K | 60 |
| NH | $3.04 | $33.1K | 10.9K | 12 |
| DE | $3.04 | $136.3K | 44.9K | 30 |
| PA | $3.03 | $477.3K | 157.3K | 112 |
| VA | $3.02 | $618.7K | 205.0K | 119 |
| PR | $2.99 | $2.1K | 718 | 2 |
| NV | $2.98 | $240.3K | 80.7K | 27 |
| TX | $2.94 | $2.0M | 674.9K | 378 |
| ND | $2.89 | $18.7K | 6.5K | 5 |
| AZ | $2.88 | $984.7K | 342.0K | 109 |
| MN | $2.87 | $110.0K | 38.3K | 38 |
| LA | $2.85 | $142.9K | 50.2K | 34 |
| VT | $2.83 | $18.6K | 6.6K | 2 |
| OH | $2.83 | $535.7K | 189.2K | 95 |
| GA | $2.82 | $508.4K | 180.4K | 113 |
| WV | $2.80 | $79.3K | 28.3K | 14 |
| MO | $2.79 | $325.3K | 116.5K | 67 |
| UT | $2.79 | $96.2K | 34.5K | 23 |
| NC | $2.79 | $503.2K | 180.4K | 107 |
| NM | $2.78 | $90.8K | 32.7K | 20 |
| OR | $2.78 | $94.4K | 34.0K | 31 |
| ME | $2.77 | $25.3K | 9.2K | 8 |
| MT | $2.76 | $29.7K | 10.7K | 8 |
| SC | $2.75 | $520.4K | 189.0K | 81 |
| KY | $2.73 | $456.3K | 167.4K | 70 |
| OK | $2.71 | $137.5K | 50.7K | 25 |
| IN | $2.69 | $299.9K | 111.3K | 68 |
| AL | $2.69 | $128.3K | 47.6K | 44 |
| WI | $2.67 | $68.0K | 25.5K | 37 |
| SD | $2.66 | $28.2K | 10.6K | 9 |
| MS | $2.65 | $116.4K | 44.0K | 25 |
| KS | $2.64 | $84.3K | 31.9K | 26 |
| IA | $2.64 | $159.5K | 60.5K | 34 |
| TN | $2.61 | $547.1K | 209.9K | 100 |
| NE | $2.60 | $70.0K | 26.9K | 22 |
| AR | $2.52 | $244.4K | 97.0K | 42 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Zinovy Lekht | Neurosurgery | CA | $161.9K | 45.2K | $3.58 |
| Yousef Mehrabi | General Practice | CA | $118.2K | 32.6K | $3.62 |
| Richard Hubbard | Neurology | CA | $111.4K | 31.2K | $3.58 |
| Fernando Enrile | General Practice | CA | $106.6K | 29.4K | $3.62 |
| Adrienne Grant | General Practice | CA | $95.8K | 26.5K | $3.61 |
| Rk Med Imaging Inc | Independent Diagnostic Testing Facility (IDTF) | NY | $82.2K | 20.0K | $4.12 |
| Sunil Mehra | Pulmonary Disease | NY | $82.2K | 20.5K | $4.01 |
| Richard Bardowell | General Practice | CA | $76.8K | 21.2K | $3.62 |
| Krikor Tatoyan | Internal Medicine | CA | $76.1K | 21.1K | $3.61 |
| Michael Wein | Allergy/ Immunology | FL | $74.7K | 22.0K | $3.39 |
| Chiraag Patel | Allergy/ Immunology | CA | $72.7K | 22.1K | $3.29 |
| Thomas Johnson | Allergy/ Immunology | FL | $68.6K | 22.4K | $3.06 |
| Luna Healing Solution Inc | Independent Diagnostic Testing Facility (IDTF) | NY | $68.0K | 16.5K | $4.12 |
| Ajay Agarwala | Cardiology | NY | $67.3K | 18.4K | $3.65 |
| Edward Young | Dermatology | CA | $66.1K | 18.2K | $3.62 |
| Aron Rubin | Pulmonary Disease | NY | $65.7K | 16.0K | $4.10 |
| Andrew Engler | Allergy/ Immunology | CA | $61.3K | 14.9K | $4.11 |
| Dennis Dilley | Allergy/ Immunology | TX | $59.7K | 20.2K | $2.95 |
| Peter Logalbo | Allergy/ Immunology | NY | $59.3K | 14.3K | $4.14 |
| Charles Greene | Otolaryngology | FL | $51.6K | 16.9K | $3.05 |
Based on the data, CPT 95004 shows a 1.6x variation in pricing across states — moderate variation by Medicare standards.
Costs have decreased 37.6% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.