70551

Mri scan of brain without contrast

Code 70551. Medicare covered 1,162,275 of these. Here is what providers billed and what Medicare allowed, state by state.

$666.15Billed, national avg
$94.41Medicare allowed
7.1xBilled vs allowed
4.9xHighest vs lowest state

Providers in Alaska billed the most for this, at $1,246.70. In Guam the average was $251.97. 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$1,246.70$108.6211.5x3,113
New York$1,001.56$126.927.9x84,774
New Jersey$908.05$117.887.7x37,928
Nevada$855.17$104.058.2x10,519
Florida$842.09$106.937.9x84,757
Wisconsin$838.18$73.6811.4x15,685
Arizona$797.57$100.328.0x24,817
Texas$755.03$90.858.3x85,671
California$732.72$112.316.5x129,815
South Carolina$729.40$85.498.5x19,060
Massachusetts$695.67$94.367.4x41,017
Wyoming$693.17$88.157.9x1,819
District of Columbia$688.93$119.715.8x5,858
Colorado$668.07$97.646.8x21,648
Connecticut$656.68$90.487.3x14,152
New Hampshire$654.64$75.258.7x6,931
Georgia$645.51$87.117.4x34,364
Maryland$641.86$115.765.5x31,270
Virginia$630.23$87.207.2x33,600
Illinois$613.27$81.997.5x42,396
Minnesota$602.67$84.917.1x31,193
North Carolina$560.31$80.137.0x39,745
Rhode Island$559.78$97.295.8x4,643
Mississippi$557.02$79.787.0x11,293
Ohio$556.52$78.867.1x32,444
New Mexico$545.42$84.696.4x4,450
West Virginia$539.88$80.956.7x4,763
Iowa$536.90$75.377.1x8,576
Louisiana$534.81$80.376.7x14,230
Tennessee$520.65$79.886.5x30,572
Pennsylvania$513.06$82.496.2x46,332
Washington$508.34$88.985.7x22,268
Hawaii$505.16$99.065.1x2,920
Alabama$501.62$81.826.1x18,186
Oregon$483.64$85.675.6x10,668
Idaho$476.57$73.036.5x5,546
Oklahoma$466.41$76.346.1x11,998
Maine$459.71$85.335.4x5,667
Delaware$457.03$85.285.4x7,345
Michigan$435.47$81.765.3x22,095
Utah$416.52$76.905.4x8,564
Vermont$414.21$74.665.5x2,303
Indiana$401.30$72.635.5x18,373
Kentucky$385.45$75.045.1x11,005
Missouri$381.60$71.175.4x22,902
Puerto Rico$358.96$141.982.5x1,217
South Dakota$354.39$74.764.7x2,625
Armed Forces Central/South America$353.46$66.635.3x267
Nebraska$343.77$70.154.9x5,085
Arkansas$340.48$70.684.8x10,236
Kansas$337.78$72.524.7x9,135
Foreign Country$330.00$66.605.0x101
Montana$326.18$73.864.4x3,380
Unknown$300.00$69.494.3x80
North Dakota$289.72$68.314.2x2,484
Armed Forces Pacific$284.42$71.984.0x117
Guam$251.97$150.611.7x260

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

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