71046

X-ray of chest, 2 views

Code 71046. Medicare covered 6,714,671 of these. Here is what providers billed and what Medicare allowed, state by state.

$71.87Billed, national avg
$16.49Medicare allowed
4.4xBilled vs allowed
3.9xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $124.83. In Puerto Rico the average was $31.96. 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$124.83$14.628.5x120,974
Foreign Country$120.87$22.655.3x261
Alaska$107.33$19.065.6x14,170
Virgin Islands$105.87$25.644.1x612
Arizona$99.12$20.844.8x104,429
California$96.43$21.254.5x537,539
Nevada$94.00$19.044.9x41,290
Texas$93.58$17.375.4x417,903
South Carolina$90.16$15.795.7x110,584
Florida$89.87$20.024.5x373,949
Wyoming$89.18$16.685.3x10,207
New Hampshire$85.78$13.316.4x44,322
Armed Forces Pacific$84.07$14.265.9x1,426
New York$82.15$19.574.2x382,396
Illinois$78.60$14.215.5x303,404
Georgia$76.54$17.064.5x181,925
New Mexico$73.72$14.944.9x22,259
Idaho$72.73$12.755.7x28,312
Colorado$72.18$15.834.6x80,225
Armed Forces Europe$72.01$20.833.5x123
Minnesota$71.00$14.984.7x194,335
Virginia$70.88$16.344.3x185,066
New Jersey$69.16$19.963.5x180,787
Oklahoma$68.01$15.164.5x95,092
Vermont$67.76$11.775.8x14,719
Louisiana$67.32$14.834.5x96,785
Mississippi$67.02$15.964.2x93,384
North Carolina$66.80$15.024.4x258,452
Tennessee$65.68$17.453.8x190,574
Ohio$63.95$12.944.9x232,482
District of Columbia$63.79$17.403.7x14,522
North Dakota$62.97$13.104.8x18,493
Indiana$62.82$13.284.7x108,757
Washington$62.17$15.494.0x134,268
Kentucky$58.59$15.443.8x67,932
Rhode Island$58.56$16.173.6x37,524
Connecticut$58.54$14.814.0x71,773
Delaware$58.20$14.893.9x27,679
Armed Forces Central/South America$57.18$11.515.0x980
Pennsylvania$56.55$13.754.1x273,607
West Virginia$55.74$12.174.6x41,579
Alabama$55.48$18.613.0x122,719
Iowa$54.89$13.913.9x89,580
Missouri$52.90$13.443.9x179,180
Hawaii$52.15$15.493.4x21,865
Maryland$52.07$17.802.9x325,330
Massachusetts$52.02$14.003.7x248,693
Oregon$51.59$14.413.6x59,379
Michigan$50.85$13.943.6x191,460
Nebraska$50.46$14.813.4x64,964
Kansas$50.16$15.543.2x79,533
Utah$49.44$15.533.2x32,858
Montana$47.28$13.163.6x18,391
Arkansas$45.37$15.452.9x99,852
Maine$45.09$11.553.9x31,277
Unknown$45.00$10.414.3x166
South Dakota$44.22$13.423.3x27,836
Guam$35.84$27.881.3x1,129
Puerto Rico$31.96$20.221.6x5,352

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

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