70450

Ct scan head or brain without contrast

Code 70450. Medicare covered 4,945,922 of these. Here is what providers billed and what Medicare allowed, state by state.

$247.20Billed, national avg
$40.41Medicare allowed
6.1xBilled vs allowed
2.6xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $378.70. In South Dakota the average was $148.35. 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
Wisconsin$378.70$38.0010.0x81,263
Alaska$365.89$51.277.1x9,610
Armed Forces Central/South America$360.32$37.969.5x1,227
New Hampshire$352.93$38.719.1x29,114
Arizona$341.86$40.758.4x87,675
Texas$319.63$39.588.1x367,598
Nevada$316.47$39.837.9x40,030
Florida$289.57$41.736.9x347,623
South Carolina$288.30$38.617.5x81,063
California$267.04$44.056.1x463,904
New Jersey$264.93$43.806.0x149,368
Colorado$262.97$40.606.5x88,731
Illinois$262.35$39.786.6x234,935
Georgia$262.23$39.456.6x139,655
Wyoming$259.13$39.556.6x7,161
New York$256.51$44.845.7x284,653
Ohio$255.14$38.196.7x157,235
Idaho$254.36$37.666.8x18,042
Oklahoma$252.30$37.996.6x64,162
Foreign Country$250.64$38.246.6x389
Rhode Island$249.42$41.356.0x21,697
Tennessee$249.31$38.506.5x114,264
North Carolina$243.29$38.856.3x177,172
Virgin Islands$226.66$38.345.9x121
Connecticut$225.46$41.245.5x68,010
Mississippi$222.52$37.665.9x55,743
Virginia$220.69$39.695.6x148,825
Missouri$220.47$38.115.8x121,806
Armed Forces Europe$219.39$39.275.6x163
Vermont$218.92$37.985.8x8,255
Minnesota$218.57$39.485.5x192,130
New Mexico$217.51$39.115.6x22,943
Hawaii$215.27$40.465.3x14,083
Louisiana$213.95$38.315.6x67,468
Iowa$209.07$38.125.5x41,582
Indiana$203.24$37.855.4x92,916
North Dakota$202.43$38.175.3x10,447
Pennsylvania$201.38$39.315.1x206,979
District of Columbia$199.01$42.864.6x21,018
Delaware$196.59$39.695.0x20,675
Kentucky$195.62$38.175.1x52,191
West Virginia$193.74$38.005.1x29,911
Alabama$193.12$37.765.1x78,395
Washington$191.54$40.724.7x85,838
Maryland$190.07$44.144.3x117,314
Puerto Rico$189.96$43.714.3x5,087
Michigan$189.35$38.704.9x133,464
Armed Forces Pacific$183.21$41.364.4x697
Massachusetts$181.70$40.734.5x149,453
Oregon$181.02$39.684.6x37,845
Unknown$180.00$39.474.6x400
Maine$178.59$39.544.5x15,501
Nebraska$173.12$37.534.6x37,474
Montana$171.80$39.344.4x13,571
Arkansas$160.01$36.804.3x46,659
Utah$156.19$38.394.1x25,594
Kansas$155.55$37.594.1x46,004
Guam$155.48$48.373.2x732
South Dakota$148.35$38.953.8x10,046

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

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