71260

Ct scan of chest with contrast

Code 71260. Medicare covered 1,846,940 of these. Here is what providers billed and what Medicare allowed, state by state.

$434.77Billed, national avg
$62.45Medicare allowed
7.0xBilled vs allowed
4.4xHighest vs lowest state

Providers in Alaska billed the most for this, at $866.60. In Guam the average was $198.24. 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$866.60$80.5210.8x5,150
Wisconsin$648.28$55.7011.6x33,697
New Hampshire$582.89$55.4910.5x10,954
Arizona$558.52$69.808.0x33,865
California$546.33$72.797.5x150,784
Florida$539.77$75.607.1x104,046
Virginia$524.30$61.478.5x55,994
South Carolina$512.68$60.478.5x33,403
Minnesota$511.20$65.177.8x67,202
Wyoming$506.26$58.998.6x3,311
New York$501.15$67.417.4x113,959
Texas$489.08$59.758.2x148,813
New Jersey$478.26$70.876.7x41,255
Mississippi$473.88$54.038.8x18,817
Nevada$466.71$69.466.7x9,372
Illinois$462.74$60.077.7x82,800
Maryland$462.48$78.965.9x43,425
New Mexico$446.33$62.967.1x7,361
District of Columbia$434.66$69.726.2x6,067
North Carolina$422.35$58.647.2x65,854
Tennessee$416.56$61.536.8x54,105
Iowa$411.74$59.057.0x21,279
Connecticut$408.43$62.506.5x19,854
Georgia$401.80$58.096.9x39,978
Armed Forces Central/South America$388.96$52.907.4x477
Colorado$388.81$60.796.4x33,313
Foreign Country$385.64$50.237.7x28
Missouri$376.01$54.706.9x50,838
Ohio$374.05$55.136.8x57,305
Vermont$363.16$53.406.8x4,517
Arkansas$361.65$65.695.5x26,682
Washington$357.47$63.745.6x38,847
Armed Forces Europe$355.47$53.766.6x19
Idaho$346.07$54.326.4x9,947
Hawaii$345.43$62.365.5x4,580
Montana$336.93$57.055.9x5,760
Massachusetts$331.69$60.275.5x73,068
Unknown$327.57$65.805.0x296
Armed Forces Pacific$321.79$67.924.7x219
Louisiana$320.92$54.795.9x16,752
Pennsylvania$318.85$56.465.6x84,842
Rhode Island$309.93$60.925.1x7,939
Oregon$307.12$58.195.3x20,556
Nebraska$305.76$54.565.6x19,702
Delaware$304.28$58.845.2x7,217
Indiana$301.34$54.725.5x35,189
Alabama$292.94$60.624.8x23,456
North Dakota$290.44$52.955.5x6,023
Oklahoma$288.94$52.895.5x22,462
Kentucky$286.45$54.875.2x20,083
Michigan$285.51$54.375.3x50,742
Virgin Islands$270.00$52.145.2x40
Utah$267.86$63.264.2x9,358
West Virginia$262.30$52.085.0x8,952
Maine$261.82$54.814.8x6,994
Kansas$259.36$55.294.7x22,585
South Dakota$243.81$55.244.4x6,045
Puerto Rico$209.34$78.082.7x588
Guam$198.24$80.272.5x174

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

← All procedures