Ingest challenge ini 120 min
Food allergy challenge testing over two hours costs between $62.77 at Medicare rates and $530.60 at hospital outpatient facilities, with charges reaching 8.5x the Medicare benchmark depending on your provider's billing practices.
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
This procedure tests whether a patient has an allergic reaction to a specific food or medication by having them consume it under medical supervision during the initial 120-minute observation period. Patients with suspected food allergies or drug sensitivities typically receive this test when other allergy tests are inconclusive. Code 95076 requires prior authorization from most insurers and charges approximately 8.5x the Medicare reimbursement rate.
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Facility rate
$63
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 95076
Facility vs office setting
$36 differenceFacility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $63 | Lowest |
| Non-facility (office) | $99 | +58% |
| Outpatient (APC) | $531 | +745% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Related procedures
Related pricing data
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use