80076

Liver function blood test panel

Code 80076. Medicare covered 1,178,776 of these. Here is what providers billed and what Medicare allowed, state by state.

$44.28Billed, national avg
$7.99Medicare allowed
5.5xBilled vs allowed
10.9xHighest vs lowest state

Providers in Wisconsin billed the most for this, at $88.80. In Virgin Islands the average was $8.17. 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
Wisconsin$88.80$7.9311.2x13,545
Alaska$86.79$8.0110.8x137
Illinois$68.92$7.988.6x26,190
North Dakota$61.34$8.007.7x1,486
California$58.88$8.007.4x143,123
New York$58.54$8.007.3x41,886
Iowa$57.04$7.977.2x6,598
Kansas$56.14$8.007.0x13,285
Wyoming$52.96$7.986.6x418
New Mexico$52.46$7.986.6x1,150
South Carolina$52.18$7.986.5x95,903
Texas$50.43$7.976.3x77,131
South Dakota$50.36$7.996.3x3,710
Massachusetts$50.02$8.006.3x36,545
New Jersey$49.35$8.006.2x89,910
Mississippi$47.62$7.956.0x24,593
Louisiana$46.46$7.995.8x7,486
Minnesota$44.34$7.965.6x10,903
Florida$44.33$8.005.5x62,944
Georgia$43.64$7.975.5x28,752
Rhode Island$43.23$8.005.4x2,192
Washington$42.68$7.985.3x12,037
North Carolina$40.09$7.995.0x94,868
Idaho$39.79$7.905.0x415
Nevada$39.72$8.005.0x6,301
Connecticut$39.61$7.955.0x1,881
Colorado$39.21$7.984.9x8,664
Pennsylvania$39.08$7.994.9x20,527
Guam$36.90$8.014.6x19
Maryland$36.75$7.994.6x13,877
District of Columbia$36.42$8.014.5x66
Indiana$35.77$7.974.5x6,905
Vermont$35.33$8.014.4x15
Ohio$35.27$7.984.4x38,215
Montana$35.12$8.004.4x787
Oklahoma$34.61$7.994.3x8,530
Arkansas$32.96$7.974.1x10,139
New Hampshire$32.95$7.984.1x548
Michigan$31.83$7.994.0x12,212
Hawaii$31.13$7.973.9x7,350
Missouri$30.94$7.963.9x7,105
Tennessee$30.61$7.963.8x55,212
Alabama$30.52$7.983.8x27,919
Kentucky$29.86$7.993.7x9,451
Virginia$29.31$7.983.7x41,579
Oregon$28.65$7.983.6x5,423
West Virginia$27.54$7.963.5x856
Nebraska$26.10$7.993.3x2,017
Maine$24.18$7.973.0x871
Utah$19.22$7.972.4x3,217
Arizona$18.56$8.012.3x92,037
Delaware$12.87$8.011.6x853
Puerto Rico$9.12$7.971.1x936
Virgin Islands$8.17$8.011.0x24

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

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