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Based on public Medicaid payment data.

Average Medicaid Pulmonary Function Test Payments

Typical Medicaid Pulmonary Function Test reimbursement across 4,055 cities

Avg. Medicaid Paid

$29.59

Price Range

$0.00 – $938.16

Total Claims

19.4M

Cities

4055

Typical Payment Range

Typical Medicaid Pulmonary Function Test payments fall between $7.79 and $27.18 per claim (median: $14.27). The top 10% of payments exceed $63.77.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Pulmonary function tests (PFTs) measure how well the lungs work. Used to diagnose and monitor lung diseases like asthma, COPD, and pulmonary fibrosis.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
New Britain, CT $20.19 $2.01 – $22.13 25,189 7
Morgantown, WV $28.01 $0.00 – $212.79 24,895 20
Owensboro, KY $36.45 $3.89 – $182.60 24,869 19
Huntington, WV $24.39 $0.00 – $76.50 24,735 24
High Point, NC $15.73 $8.36 – $31.91 24,629 27
Loma Linda, CA $18.85 $0.00 – $35.20 24,328 18
Stamford, CT $18.91 $0.00 – $22.86 24,290 14
Las Cruces, NM $49.58 $9.93 – $198.54 23,861 24
Redding, CA $48.56 $0.00 – $96.62 23,614 11
Port Huron, MI $11.53 $2.00 – $25.68 23,607 9
Huntington Beach, CA $24.91 $0.08 – $177.91 23,526 8
Jamaica, NY $25.38 $0.71 – $154.10 23,422 16
Danbury, CT $29.26 $3.23 – $35.81 23,052 22
Scottsdale, AZ $17.96 $0.00 – $76.16 22,948 29
Huntsville, AL $44.05 $0.00 – $48.53 22,935 34
Kew Gardens, NY $32.79 $18.98 – $43.90 22,843 4
Glasgow, KY $44.37 $8.72 – $59.35 22,819 4
Anaheim, CA $25.99 $0.00 – $93.01 22,704 21
Lewiston, ME $16.81 $3.13 – $21.41 22,510 14
Peoria, AZ $26.28 $0.00 – $30.45 22,373 26
Morristown, NJ $108.87 $5.65 – $150.88 22,236 11
Alexandria, VA $46.63 $5.66 – $62.18 21,884 12
Gonzales, LA $18.12 $7.78 – $35.75 21,847 8
New Hyde Park, NY $18.69 $3.47 – $62.14 21,825 22
Apple Valley, CA $22.05 $0.00 – $39.82 21,699 12
Forest Hills, NY $31.17 $7.78 – $49.44 21,651 18
Kingman, AZ $48.57 $0.00 – $57.32 21,608 11
Mayaguez, PR $55.20 $0.00 – $65.53 21,471 11
Midland, MI $12.16 $5.50 – $32.73 21,360 9
Anchorage, AK $80.33 $1.91 – $104.56 21,266 23
Oroville, CA $24.55 $0.00 – $40.18 21,256 4
Vancouver, WA $14.57 $4.83 – $38.81 21,149 17
South Boston, VA $15.91 $10.00 – $34.10 21,108 7
Rego Park, NY $16.57 $7.24 – $64.69 21,071 8
Gilbert, AZ $21.40 $0.00 – $34.93 21,015 19
Minneapolis, MN $37.47 $0.00 – $159.74 21,006 93
Shreveport, LA $29.81 $0.00 – $140.55 20,954 61
San Luis Obispo, CA $31.01 $0.00 – $40.64 20,841 10
Laveen, AZ $0.30 $0.30 – $0.30 20,461 1
La Mesa, CA $51.05 $0.00 – $425.38 20,369 9
La Crosse, WI $21.68 $0.86 – $145.99 20,173 11
Gallipolis, OH $25.09 $5.51 – $155.47 19,919 12
St Petersburg, FL $34.74 $0.00 – $154.00 19,713 24
Lima, OH $48.21 $0.00 – $174.86 19,694 20
Corona, CA $42.94 $0.00 – $53.84 19,687 12
Visalia, CA $14.17 $0.00 – $22.80 19,658 11
Augusta, ME $22.68 $4.63 – $23.12 19,559 5
Portland, ME $13.75 $5.00 – $23.54 19,524 13
Mount Clemens, MI $17.09 $4.52 – $119.00 19,358 5
Springfield, MO $33.53 $4.11 – $568.21 19,325 44

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
94640 Airway inhalation treatment $30.37 8,609,434 12,427
94010 Spirometry $25.10 3,948,184 7,404
94060 Spirometry pre & post bronch $45.36 2,638,065 6,502
94729 Diffusing capacity (DLCO) $21.36 2,183,703 5,880
94726 Plethysmography lung volumes $26.97 1,341,614 4,152
94375 Respiratory flow volume loop $31.08 795,469 1,665
94727 Gas dilution lung volume $21.85 595,656 1,579
94200 Max breathing capacity test $12.33 463,986 451
94150 Vital capacity test $9.49 274,717 389
94660 CPAP initiation/management $42.51 104,298 247
94728 Airway resistance oscillometry $26.43 61,324 92
94621 Pulmonary stress test complex $95.35 35,949 133
94070 Bronchospasm provocation eval $88.04 17,656 86
94620 Pulmonary stress test simple $7.99 35 1

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.