76770

Complete ultrasound scan behind abdominal cavity

Code 76770. Medicare covered 1,280,211 of these. Here is what providers billed and what Medicare allowed, state by state.

$246.73Billed, national avg
$58.69Medicare allowed
4.2xBilled vs allowed
3.8xHighest vs lowest state

Providers in Alaska billed the most for this, at $442.65. In Puerto Rico the average was $115.15. 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$442.65$65.326.8x2,276
Wisconsin$376.63$41.929.0x14,240
Arizona$352.90$68.875.1x24,814
Virgin Islands$344.12$90.123.8x175
Nevada$308.77$65.264.7x14,750
New Jersey$308.48$83.803.7x47,798
New Hampshire$298.93$42.787.0x5,357
New York$294.36$72.644.1x112,446
Texas$292.62$55.685.3x79,653
Florida$280.14$64.804.3x93,067
New Mexico$277.36$57.594.8x6,273
California$274.83$77.313.6x166,135
Wyoming$272.60$56.844.8x1,374
Georgia$261.84$54.744.8x40,988
South Carolina$261.33$47.645.5x20,422
Foreign Country$259.26$33.917.6x234
Armed Forces Pacific$257.97$59.014.4x130
Armed Forces Central/South America$251.74$33.767.5x121
Virginia$251.12$56.394.5x36,157
Idaho$250.02$45.465.5x4,054
Tennessee$247.99$55.224.5x32,633
District of Columbia$247.79$57.574.3x3,740
Hawaii$245.03$58.394.2x3,419
Colorado$243.23$52.414.6x13,707
Illinois$227.44$51.234.4x46,101
Rhode Island$226.83$55.504.1x3,921
Minnesota$222.51$48.874.6x20,175
Ohio$220.65$38.455.7x33,873
Mississippi$219.64$57.283.8x15,132
North Carolina$219.03$48.984.5x36,865
Connecticut$218.75$59.043.7x18,713
Maryland$218.64$68.263.2x35,467
Louisiana$210.82$47.834.4x17,734
Massachusetts$208.77$54.023.9x44,180
Vermont$205.53$41.764.9x1,652
Washington$205.33$53.253.9x20,116
Iowa$202.60$42.324.8x9,634
Pennsylvania$199.53$44.754.5x47,705
West Virginia$198.65$44.164.5x5,533
Nebraska$197.53$44.774.4x6,737
Delaware$189.59$55.353.4x6,973
Oregon$187.11$49.153.8x10,103
South Dakota$175.59$45.853.8x3,640
Indiana$175.26$42.154.2x18,881
Alabama$173.39$43.993.9x18,849
Michigan$168.56$45.403.7x42,297
North Dakota$167.19$38.524.3x3,409
Missouri$167.10$43.383.9x23,252
Unknown$160.00$112.051.4x225
Kentucky$158.53$46.173.4x13,032
Arkansas$158.46$41.973.8x14,782
Oklahoma$157.76$39.504.0x16,041
Utah$156.87$48.633.2x5,019
Kansas$156.23$44.423.5x8,662
Maine$141.35$40.003.5x3,653
Montana$136.97$39.413.5x1,790
Guam$123.32$90.101.4x264
Puerto Rico$115.15$77.191.5x1,829

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

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