76705

Limited ultrasound scan of abdomen

Code 76705. Medicare covered 1,044,421 of these. Here is what providers billed and what Medicare allowed, state by state.

$184.24Billed, national avg
$36.62Medicare allowed
5.0xBilled vs allowed
3.4xHighest vs lowest state

Providers in Foreign Country billed the most for this, at $333.38. In Guam the average was $97.00. 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
Foreign Country$333.38$27.2312.2x205
Virgin Islands$307.84$86.073.6x40
Wisconsin$301.31$31.639.5x18,950
Alaska$266.14$44.646.0x2,825
Arizona$242.23$40.296.0x15,999
Florida$231.64$42.115.5x68,751
Wyoming$229.64$40.185.7x1,815
Texas$225.17$35.536.3x63,549
New Hampshire$218.48$30.297.2x6,064
California$218.39$45.914.8x112,703
Armed Forces Pacific$214.83$41.335.2x172
Armed Forces Central/South America$212.72$26.398.1x167
South Carolina$208.74$33.866.2x18,420
Nevada$207.96$38.085.5x7,751
Virginia$207.02$34.626.0x32,681
Colorado$202.52$39.265.2x17,312
New York$200.89$42.294.8x62,070
New Jersey$200.15$44.264.5x26,029
Hawaii$192.50$42.784.5x2,702
Georgia$189.93$33.495.7x29,154
Ohio$187.13$29.646.3x36,733
Illinois$186.37$34.825.4x51,331
New Mexico$180.28$34.105.3x4,835
Rhode Island$178.38$43.414.1x4,650
Armed Forces Europe$174.38$27.126.4x16
Iowa$173.71$34.225.1x11,160
North Carolina$173.24$36.004.8x37,113
District of Columbia$172.66$39.964.3x3,170
Tennessee$169.66$36.094.7x24,059
Minnesota$167.02$33.095.0x26,960
Mississippi$165.48$32.615.1x11,458
Idaho$165.24$29.395.6x4,514
Oklahoma$164.77$30.095.5x14,638
Washington$162.88$37.274.4x22,122
Vermont$162.19$27.795.8x2,714
Connecticut$157.39$35.984.4x11,993
North Dakota$152.62$30.395.0x3,522
Maryland$152.03$47.433.2x26,899
Puerto Rico$148.47$34.844.3x218
Louisiana$145.13$29.544.9x12,188
Pennsylvania$145.01$32.044.5x47,471
Indiana$144.20$29.394.9x19,839
Oregon$137.53$35.493.9x10,413
Nebraska$135.52$30.164.5x6,685
Michigan$135.03$29.704.5x29,724
Massachusetts$134.21$33.224.0x31,382
Delaware$133.84$35.553.8x4,209
West Virginia$132.43$29.264.5x7,939
Kentucky$132.07$30.494.3x13,694
Missouri$128.34$29.844.3x25,277
Kansas$122.03$34.823.5x10,645
Unknown$120.00$27.484.4x34
Montana$118.20$30.373.9x2,876
Utah$116.70$32.783.6x4,563
Alabama$115.64$34.483.4x14,098
Maine$114.58$28.484.0x4,742
Arkansas$114.55$29.823.8x9,603
South Dakota$111.30$31.763.5x3,253
Guam$97.00$59.891.6x302

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

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