82550

Creatine kinase (cardiac enzyme) level, total

Code 82550. Medicare covered 1,283,205 of these. Here is what providers billed and what Medicare allowed, state by state.

$37.83Billed, national avg
$6.37Medicare allowed
5.9xBilled vs allowed
8.4xHighest vs lowest state

Providers in Nevada billed the most for this, at $58.20. In Puerto Rico the average was $6.89. 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
Nevada$58.20$6.379.1x13,077
Alaska$51.58$6.178.4x84
Georgia$50.22$6.367.9x32,278
Kansas$48.20$6.387.6x20,799
Wyoming$48.01$6.327.6x244
New Jersey$47.07$6.387.4x165,034
Maryland$46.13$6.377.2x16,998
Massachusetts$45.86$6.387.2x32,177
Illinois$45.65$6.377.2x26,090
California$43.28$6.376.8x162,768
Florida$41.66$6.386.5x126,052
Texas$41.25$6.376.5x119,264
Wisconsin$41.13$6.286.5x7,512
New York$40.33$6.376.3x97,963
North Carolina$38.55$6.376.0x75,568
Colorado$38.41$6.376.0x5,715
Rhode Island$37.79$6.375.9x2,216
District of Columbia$37.20$6.385.8x143
Pennsylvania$35.82$6.375.6x13,628
Minnesota$34.98$6.325.5x6,423
Ohio$33.50$6.375.3x34,691
Guam$33.30$5.955.6x15
Washington$32.89$6.355.2x9,379
Montana$32.38$6.355.1x216
Connecticut$32.10$6.335.1x1,726
North Dakota$31.56$6.384.9x965
Oklahoma$31.09$6.374.9x13,297
Alabama$30.26$6.364.8x36,773
New Hampshire$29.76$6.384.7x1,053
Idaho$29.09$6.324.6x502
New Mexico$28.48$6.324.5x1,818
Mississippi$28.44$6.324.5x4,418
South Dakota$26.85$6.364.2x2,318
Arkansas$26.56$6.344.2x4,550
Indiana$26.19$6.354.1x11,689
South Carolina$25.74$6.334.1x13,916
Tennessee$25.61$6.354.0x43,789
Hawaii$25.17$6.354.0x6,264
Virginia$24.32$6.353.8x13,433
Oregon$23.44$6.353.7x4,119
Kentucky$23.14$6.363.6x5,200
Missouri$22.01$6.333.5x7,402
Iowa$20.98$6.343.3x2,593
Nebraska$20.86$6.363.3x6,021
Louisiana$20.64$6.353.3x10,685
Maine$20.63$6.363.2x605
Michigan$18.87$6.353.0x13,820
West Virginia$16.10$6.372.5x767
Arizona$15.91$6.382.5x102,364
Utah$15.82$6.332.5x2,581
Delaware$12.06$6.381.9x51
Virgin Islands$8.72$6.381.4x65
Puerto Rico$6.89$6.251.1x2,067

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

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