71275

Ct scan of blood vessels of chest with contrast

Code 71275. Medicare covered 1,555,203 of these. Here is what providers billed and what Medicare allowed, state by state.

$532.72Billed, national avg
$90.07Medicare allowed
5.9xBilled vs allowed
3.9xHighest vs lowest state

Providers in Armed Forces Central/South America billed the most for this, at $1,239.55. In Guam the average was $318.10. 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
Armed Forces Central/South America$1,239.55$80.8815.3x292
Foreign Country$1,171.10$84.3613.9x21
Alaska$865.89$125.656.9x3,893
Arizona$834.71$96.188.7x32,236
Wisconsin$809.76$84.539.6x28,366
Nevada$720.59$90.618.0x14,984
Texas$685.80$88.627.7x105,778
Florida$663.29$96.156.9x107,376
Idaho$634.26$81.947.7x9,798
New York$596.76$104.185.7x73,373
California$587.74$98.606.0x131,231
New Hampshire$584.36$84.736.9x9,632
Ohio$582.95$84.416.9x51,297
Illinois$567.66$89.916.3x73,357
Colorado$559.27$90.936.2x35,674
Wyoming$557.63$87.216.4x3,194
North Carolina$553.28$87.006.4x58,807
Georgia$551.58$86.226.4x42,956
Minnesota$544.36$88.036.2x68,215
Tennessee$536.07$86.476.2x36,257
New Jersey$523.92$99.125.3x36,494
Connecticut$505.41$90.955.6x18,592
Mississippi$490.55$84.375.8x14,153
Louisiana$481.19$85.585.6x14,365
District of Columbia$478.64$97.044.9x5,793
Rhode Island$476.88$89.065.4x7,059
New Mexico$473.97$87.435.4x7,633
South Carolina$473.92$84.545.6x26,798
Hawaii$460.49$87.335.3x4,411
Virginia$459.31$88.195.2x54,254
Oklahoma$456.58$81.655.6x16,247
Vermont$455.47$82.875.5x2,763
Delaware$447.36$88.325.1x5,495
Kentucky$433.49$82.955.2x17,751
Missouri$419.83$83.185.0x40,893
Iowa$419.53$84.555.0x14,294
Armed Forces Pacific$416.77$96.454.3x241
Pennsylvania$409.40$85.924.8x63,378
Unknown$406.78$110.433.7x65
Indiana$405.95$81.895.0x33,192
Maryland$405.59$99.544.1x41,596
West Virginia$404.69$81.844.9x9,855
Michigan$400.97$84.604.7x47,225
Massachusetts$395.41$89.294.4x44,717
Armed Forces Europe$394.74$82.794.8x56
Oregon$390.58$86.794.5x14,639
Montana$389.28$84.664.6x5,350
Nebraska$384.19$82.744.6x12,663
Washington$383.02$89.274.3x33,413
Maine$374.70$84.234.4x4,922
Utah$345.67$87.593.9x10,678
Puerto Rico$344.65$93.543.7x846
North Dakota$335.49$83.144.0x3,796
Alabama$331.85$84.993.9x22,155
Kansas$329.08$83.983.9x14,177
Arkansas$327.84$82.264.0x13,514
South Dakota$324.38$83.523.9x4,791
Guam$318.10$135.272.4x201

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

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