51798

Ultrasound measurement of bladder capacity after voiding

Code 51798. Medicare covered 1,918,942 of these. Here is what providers billed and what Medicare allowed, state by state.

$70.89Billed, national avg
$11.32Medicare allowed
6.3xBilled vs allowed
7.9xHighest vs lowest state

Providers in Alaska billed the most for this, at $276.68. In Nevada the average was $34.87. Same procedure code, same programme.

Whose price this is

These are Medicare figures. The billed column is what providers asked for. The allowed column is what Medicare agreed to pay. Neither is what an uninsured patient gets charged, and neither is what a private insurer negotiates.

The gap between the two columns is the point. A hospital billing three times what Medicare allows tells you the billed number was never a price. It was an opening position.

By state

StateBilledMedicare allowedGapServices
Alaska$276.68$11.8423.4x2,692
Wisconsin$172.68$10.4216.6x15,208
Minnesota$110.70$11.449.7x19,812
New York$108.57$13.088.3x155,207
Illinois$103.95$11.329.2x92,586
New Jersey$97.57$12.577.8x74,130
Massachusetts$94.54$12.347.7x62,677
New Hampshire$92.00$11.617.9x7,309
California$88.89$13.196.7x170,683
Indiana$80.77$10.098.0x38,638
West Virginia$76.84$9.727.9x2,074
Connecticut$75.76$12.376.1x21,121
Nebraska$71.11$9.927.2x15,747
Alabama$70.35$9.567.4x21,007
Missouri$68.13$10.266.6x38,376
Pennsylvania$67.98$11.286.0x91,869
Hawaii$66.04$12.425.3x1,990
South Dakota$65.01$10.786.0x6,158
North Dakota$63.52$10.905.8x356
Georgia$63.38$10.466.1x49,390
Virginia$62.60$11.155.6x55,828
South Carolina$61.44$10.365.9x39,642
District of Columbia$60.15$13.214.6x4,517
Maine$58.40$10.885.4x2,725
Florida$57.44$11.175.1x188,783
Louisiana$56.41$9.945.7x21,386
Delaware$56.25$11.275.0x12,578
Washington$56.21$11.994.7x24,479
Ohio$56.13$10.285.5x38,207
North Carolina$54.78$10.375.3x57,800
Oklahoma$53.80$9.835.5x37,958
Texas$53.70$10.864.9x145,306
Oregon$52.13$11.234.6x17,887
Vermont$51.91$10.554.9x447
Tennessee$51.91$9.955.2x57,081
New Mexico$51.63$10.405.0x4,375
Kentucky$51.47$9.925.2x17,675
Maryland$51.45$12.114.2x50,842
Arizona$50.91$10.754.7x58,813
Mississippi$49.72$9.485.2x19,916
Montana$49.68$11.214.4x2,760
Wyoming$49.52$10.894.5x4,424
Colorado$49.01$11.614.2x28,772
Arkansas$47.53$9.445.0x22,955
Iowa$47.08$10.054.7x16,183
Kansas$46.37$10.084.6x16,426
Idaho$42.68$10.184.2x6,665
Utah$41.84$10.364.0x10,203
Guam$40.76$12.793.2x183
Virgin Islands$40.05$11.033.6x346
Michigan$39.70$10.873.7x43,142
Rhode Island$38.48$11.413.4x5,227
Puerto Rico$35.01$10.703.3x961
Nevada$34.87$11.093.1x17,363

Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.

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