74177

Ct scan of abdomen and pelvis with contrast

Code 74177. Medicare covered 3,649,661 of these. Here is what providers billed and what Medicare allowed, state by state.

$617.25Billed, national avg
$106.57Medicare allowed
5.8xBilled vs allowed
3.8xHighest vs lowest state

Providers in Alaska billed the most for this, at $1,156.08. In Puerto Rico the average was $301.81. 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$1,156.08$138.268.4x9,854
Wisconsin$1,003.81$94.6510.6x67,597
Armed Forces Central/South America$937.36$83.2411.3x768
Arizona$873.34$124.437.0x70,377
South Carolina$798.09$104.687.6x65,783
Texas$777.54$106.147.3x264,774
Florida$769.55$124.736.2x223,662
New Hampshire$762.14$89.648.5x22,842
Nevada$700.94$106.496.6x26,484
New Jersey$681.52$127.105.4x92,166
California$681.28$120.705.6x313,685
Georgia$667.47$96.196.9x91,664
Virginia$665.98$103.916.4x114,923
Wyoming$664.27$105.216.3x6,903
New York$659.84$124.895.3x213,283
Illinois$626.95$99.066.3x164,740
North Carolina$626.71$101.076.2x133,509
Colorado$621.18$104.875.9x74,880
Minnesota$617.25$107.475.7x152,910
Mississippi$615.07$93.616.6x34,064
New Mexico$614.39$101.526.1x18,448
District of Columbia$609.16$121.975.0x12,759
Tennessee$580.47$110.845.2x89,202
Idaho$579.33$89.886.4x21,248
Ohio$577.75$90.376.4x107,486
Rhode Island$572.14$105.475.4x18,703
Maryland$569.16$142.904.0x86,876
Vermont$550.35$88.576.2x7,334
Oklahoma$546.89$87.956.2x43,670
Connecticut$521.99$106.314.9x44,699
Iowa$506.48$100.255.1x37,298
Hawaii$503.80$99.835.0x10,145
Virgin Islands$503.00$82.816.1x45
Pennsylvania$493.30$93.185.3x157,554
Missouri$485.38$90.375.4x93,228
Louisiana$477.74$90.935.3x32,661
Nebraska$477.64$94.605.0x33,245
Washington$471.29$109.054.3x82,132
Kentucky$465.83$90.125.2x38,550
Michigan$455.98$88.065.2x103,924
Delaware$450.60$102.454.4x15,491
Indiana$448.97$90.714.9x70,934
Armed Forces Pacific$446.07$110.504.0x623
Alabama$442.44$96.724.6x47,442
Arkansas$437.69$102.344.3x31,703
Montana$434.90$94.954.6x12,017
Massachusetts$431.32$101.724.2x127,327
Armed Forces Europe$425.73$84.935.0x69
Oregon$418.33$104.624.0x39,642
Foreign Country$411.22$82.385.0x399
West Virginia$410.01$82.775.0x19,244
Unknown$407.78$163.862.5x350
North Dakota$406.97$88.184.6x9,842
Maine$405.04$94.084.3x13,187
Kansas$403.86$95.894.2x38,950
South Dakota$349.33$93.813.7x11,622
Utah$347.82$100.263.5x24,446
Guam$327.43$115.602.8x375
Puerto Rico$301.81$114.222.6x1,921

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

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