74176

Ct scan of abdomen and pelvis without contrast

Code 74176. Medicare covered 1,992,585 of these. Here is what providers billed and what Medicare allowed, state by state.

$558.96Billed, national avg
$90.66Medicare allowed
6.2xBilled vs allowed
4.6xHighest vs lowest state

Providers in Armed Forces Central/South America billed the most for this, at $1,050.45. In Puerto Rico the average was $227.02. 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$1,050.45$78.6413.4x391
Alaska$980.38$111.558.8x3,572
Wisconsin$865.15$82.2310.5x27,368
Arizona$801.22$98.468.1x36,896
Texas$732.55$89.048.2x155,469
South Carolina$694.63$85.348.1x34,251
Florida$694.15$99.807.0x161,611
Nevada$686.14$92.747.4x15,355
New Hampshire$650.69$84.287.7x8,636
Colorado$639.95$89.377.2x32,676
Georgia$636.64$86.247.4x57,900
Wyoming$623.71$89.077.0x2,784
New Jersey$618.11$102.476.0x59,383
Oklahoma$609.87$81.037.5x26,161
Foreign Country$605.53$79.077.7x135
California$595.01$100.565.9x192,213
Idaho$590.67$83.097.1x7,270
New York$574.40$105.465.4x110,798
Ohio$554.36$81.956.8x65,969
Mississippi$548.62$83.306.6x26,007
Vermont$547.74$84.216.5x2,391
North Carolina$547.73$85.036.4x63,772
District of Columbia$545.89$100.345.4x7,358
Illinois$545.13$87.156.3x90,052
Virginia$540.85$88.486.1x56,307
New Mexico$525.64$85.816.1x8,029
Tennessee$515.86$85.336.0x52,453
Hawaii$497.52$90.495.5x5,402
Armed Forces Pacific$494.97$97.255.1x270
Connecticut$491.57$91.515.4x23,212
Rhode Island$486.49$93.905.2x6,917
Minnesota$485.68$85.765.7x75,128
Louisiana$461.42$82.965.6x25,249
Armed Forces Europe$450.50$82.265.5x59
Pennsylvania$449.98$84.855.3x81,684
Maryland$440.84$105.414.2x55,569
Missouri$439.75$82.305.3x52,218
Washington$436.58$89.654.9x31,861
Kentucky$428.39$81.465.3x26,060
Michigan$427.57$82.695.2x49,052
Delaware$426.02$91.454.7x8,444
Iowa$425.24$83.135.1x12,813
Montana$415.46$84.694.9x4,577
West Virginia$413.51$78.885.2x14,908
Nebraska$411.45$81.755.0x14,443
Indiana$401.74$82.234.9x40,557
Maine$391.22$82.074.8x5,880
Alabama$390.27$83.164.7x31,944
Virgin Islands$389.15$79.364.9x47
Kansas$387.67$83.294.7x20,483
Oregon$385.87$85.644.5x14,028
Massachusetts$385.37$87.644.4x44,690
North Dakota$379.75$80.044.7x4,408
Utah$336.67$89.023.8x8,913
South Dakota$319.31$83.123.8x4,510
Arkansas$312.72$80.773.9x20,976
Guam$305.95$120.052.5x295
Unknown$262.49$87.003.0x91
Puerto Rico$227.02$99.642.3x2,673

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

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