77063

Screening 3d breast mammography

Code 77063. Medicare covered 5,805,552 of these. Here is what providers billed and what Medicare allowed, state by state.

$138.33Billed, national avg
$34.09Medicare allowed
4.1xBilled vs allowed
14.2xHighest vs lowest state

Providers in Virgin Islands billed the most for this, at $800.00. In Guam the average was $56.29. 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
Virgin Islands$800.00$44.4718.0x476
Arizona$187.71$38.714.8x114,931
California$181.98$41.084.4x476,288
New York$174.18$39.994.4x339,504
Rhode Island$173.48$37.524.6x34,745
Texas$166.16$33.325.0x347,866
New Jersey$166.14$43.463.8x168,260
Armed Forces Pacific$165.51$41.064.0x1,191
Wyoming$165.00$38.174.3x11,068
Maryland$162.68$43.473.7x139,986
District of Columbia$162.51$39.724.1x27,906
Wisconsin$159.45$30.305.3x120,191
Alaska$155.56$35.984.3x13,722
Florida$155.35$40.373.8x365,188
Illinois$149.84$31.044.8x246,397
Nevada$148.21$40.923.6x40,472
New Mexico$147.82$36.214.1x34,530
North Carolina$146.90$34.004.3x232,388
Colorado$144.99$37.303.9x85,658
Georgia$139.89$30.464.6x148,687
Delaware$139.86$35.893.9x31,922
Tennessee$138.04$31.394.4x129,766
Connecticut$137.64$37.603.7x63,133
Washington$136.98$36.273.8x138,608
Virginia$126.34$31.124.1x212,498
South Carolina$125.84$28.214.5x111,614
Hawaii$124.73$38.833.2x16,672
Oklahoma$122.33$27.834.4x67,142
Vermont$120.89$27.154.5x18,054
Minnesota$118.90$32.813.6x133,757
Mississippi$116.80$29.603.9x60,159
Ohio$115.16$28.864.0x195,576
Massachusetts$113.48$31.253.6x198,650
Louisiana$112.64$29.963.8x72,213
Idaho$110.62$27.824.0x27,303
Pennsylvania$110.42$30.073.7x290,782
Nebraska$109.36$27.584.0x60,735
Oregon$108.74$30.533.6x63,726
Arkansas$108.21$31.203.5x55,946
Armed Forces Central/South America$104.00$26.903.9x174
Iowa$103.25$31.233.3x81,191
New Hampshire$103.16$31.493.3x34,673
Missouri$100.10$29.203.4x146,955
Indiana$98.73$28.983.4x122,999
Michigan$98.33$29.913.3x140,596
Montana$95.96$30.183.2x19,871
West Virginia$95.68$26.933.6x24,828
Alabama$94.98$30.973.1x71,002
Maine$93.79$27.933.4x26,025
Puerto Rico$92.34$34.112.7x180
Utah$91.57$29.223.1x30,458
Kentucky$86.67$28.453.0x71,394
Kansas$83.98$30.542.7x78,193
South Dakota$83.00$31.242.7x27,338
North Dakota$78.78$26.213.0x31,871
Guam$56.29$54.271.0x94

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

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