What is the standard insurance baseline for CPT 95145?

The standard insurance baseline reimbursement rate is $30.69. This represents the customary allowable amount established across standard fee schedules.

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CPT 95145Medical Service

Professional Service for Preparation and Provision of 1 Stinging Insect Venom

Q: What do doctors typically charge for Professional Service for Preparation and Provision of 1 Stinging Insect Venom?

The nationwide median physician charge for Professional Service for Preparation and Provision of 1 Stinging Insect Venom (CPT 95145) is $60.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Professional service for preparation and provision of 1 stinging insect venom. Clinical pricing breakdown and utilization metrics across 3 practicing doctors nationwide.

$60.00

Peer Median Charge

Gross billed rate

$30.69

Standard Baseline

Customary allowable

2.0x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $60.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $30.69 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 95145 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"