73130

X-ray of hand, minimum of 3 views

Code 73130. Medicare covered 1,312,279 of these. Here is what providers billed and what Medicare allowed, state by state.

$87.66Billed, national avg
$23.02Medicare allowed
3.8xBilled vs allowed
4.1xHighest vs lowest state

Providers in Alaska billed the most for this, at $157.41. In Puerto Rico the average was $38.06. 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$157.41$27.095.8x2,903
Nevada$152.11$25.995.9x10,073
Wisconsin$131.55$17.127.7x18,865
Armed Forces Europe$131.48$35.693.7x27
New Hampshire$116.63$19.486.0x7,071
Arizona$112.10$27.584.1x29,140
New Jersey$109.33$29.443.7x38,115
Georgia$109.30$23.814.6x35,622
Foreign Country$104.85$19.645.3x40
Florida$102.17$28.873.5x108,765
Virgin Islands$101.69$34.962.9x84
New York$99.11$26.293.8x79,027
California$98.01$26.853.7x126,828
Illinois$95.96$21.204.5x56,785
Delaware$94.90$22.724.2x7,376
Wyoming$94.14$21.804.3x2,962
South Carolina$93.01$22.554.1x23,758
Texas$91.87$23.174.0x92,690
Virginia$87.72$22.693.9x37,000
Connecticut$86.65$24.953.5x13,688
Rhode Island$85.59$25.913.3x6,008
Indiana$83.30$20.064.2x22,208
Armed Forces Central/South America$83.16$11.897.0x140
North Carolina$82.04$21.553.8x42,236
Washington$81.26$21.573.8x26,463
Louisiana$81.08$22.723.6x23,234
Colorado$79.57$21.193.8x20,539
Tennessee$77.47$22.393.5x35,231
Pennsylvania$77.37$20.763.7x56,256
Mississippi$76.81$21.383.6x14,684
Alabama$76.38$21.743.5x19,599
Hawaii$75.44$20.803.6x3,587
Minnesota$75.44$17.534.3x27,924
Idaho$75.01$15.984.7x5,609
New Mexico$74.99$18.724.0x6,380
Massachusetts$74.47$20.553.6x39,653
Guam$74.08$35.222.1x420
District of Columbia$73.98$21.143.5x2,897
Maryland$71.91$26.762.7x41,012
Missouri$71.91$17.164.2x26,205
Kansas$70.15$20.623.4x13,345
Nebraska$69.03$19.853.5x9,167
Iowa$68.56$18.603.7x11,872
Oregon$68.37$19.593.5x11,554
Kentucky$67.18$20.473.3x13,172
Oklahoma$65.84$19.733.3x20,834
Michigan$64.97$19.683.3x34,102
Vermont$64.61$12.475.2x1,572
North Dakota$64.60$13.584.8x3,667
Montana$63.62$21.243.0x3,966
Ohio$62.46$16.123.9x41,614
Utah$61.43$21.182.9x6,944
Arkansas$59.66$19.633.0x15,401
West Virginia$55.55$13.304.2x5,203
South Dakota$53.96$17.843.0x4,891
Armed Forces Pacific$50.20$18.312.7x157
Unknown$50.00$8.505.9x12
Maine$46.31$13.523.4x3,162
Puerto Rico$38.06$22.381.7x516

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

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