73030

X-ray of shoulder, minimum of 2 views

Code 73030. Medicare covered 2,817,362 of these. Here is what providers billed and what Medicare allowed, state by state.

$90.17Billed, national avg
$22.14Medicare allowed
4.1xBilled vs allowed
5.8xHighest vs lowest state

Providers in Alaska billed the most for this, at $188.03. In Puerto Rico the average was $32.33. 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$188.03$25.877.3x6,697
Wisconsin$149.29$17.808.4x45,815
Nevada$146.20$24.975.9x23,577
Virgin Islands$134.80$29.944.5x278
Armed Forces Europe$130.25$32.624.0x24
New Hampshire$127.09$19.086.7x16,867
Delaware$120.04$24.694.9x13,326
New Jersey$117.79$28.114.2x79,771
Foreign Country$113.83$32.053.6x22
Georgia$112.85$23.904.7x73,072
Illinois$108.68$20.555.3x126,696
New York$104.54$24.184.3x152,122
Florida$103.49$26.313.9x209,907
Virginia$102.36$22.824.5x85,951
Wyoming$100.97$22.644.5x7,124
Indiana$100.12$20.624.9x53,746
Arizona$96.25$25.703.7x60,487
Vermont$96.06$11.958.0x5,604
California$94.51$24.953.8x241,282
South Carolina$92.29$23.473.9x59,593
Connecticut$92.10$24.373.8x30,498
Texas$90.03$22.464.0x185,592
District of Columbia$89.10$22.124.0x4,982
Rhode Island$85.89$24.303.5x11,004
Colorado$84.61$23.113.7x49,347
Washington$84.12$20.784.0x58,391
New Mexico$83.42$19.384.3x12,607
Tennessee$82.41$22.523.7x76,203
Louisiana$82.31$20.564.0x42,999
Mississippi$81.96$21.263.9x32,686
Pennsylvania$81.20$20.504.0x111,351
North Carolina$81.13$21.933.7x95,502
Alabama$80.86$22.273.6x39,379
Armed Forces Central/South America$80.83$11.357.1x269
Idaho$79.39$16.354.9x14,874
Massachusetts$79.29$20.553.9x84,024
Minnesota$78.32$17.454.5x60,315
Iowa$76.07$18.404.1x29,608
Missouri$75.45$17.064.4x65,970
Kentucky$72.59$22.033.3x35,776
Oregon$72.32$21.053.4x28,582
South Dakota$71.43$17.674.0x12,568
Kansas$71.28$20.583.5x34,295
Nebraska$70.30$19.753.6x23,629
Maryland$68.70$23.482.9x97,297
Guam$68.70$30.792.2x528
Montana$68.53$20.433.4x11,375
Michigan$67.65$19.493.5x69,686
Ohio$66.60$17.723.8x99,931
Hawaii$64.75$19.183.4x6,918
North Dakota$64.70$15.274.2x8,922
West Virginia$63.60$13.794.6x13,062
Utah$62.40$22.282.8x17,462
Oklahoma$62.27$18.983.3x40,489
Arkansas$59.55$19.133.1x37,492
Armed Forces Pacific$56.21$16.313.4x265
Unknown$48.00$9.175.2x30
Maine$47.38$14.163.3x9,836
Puerto Rico$32.33$22.541.4x1,640

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

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