82784

Gammaglobulin (immune system protein) measurement

Code 82784. Medicare covered 2,154,299 of these. Here is what providers billed and what Medicare allowed, state by state.

$58.20Billed, national avg
$9.09Medicare allowed
6.4xBilled vs allowed
9.3xHighest vs lowest state

Providers in South Carolina billed the most for this, at $86.35. In Virgin Islands the average was $9.28. 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
South Carolina$86.35$9.019.6x8,557
New York$81.26$9.098.9x151,538
Wisconsin$77.07$8.968.6x17,970
Missouri$70.03$9.027.8x3,556
Kansas$68.13$9.117.5x38,601
Illinois$67.56$9.097.4x42,880
Minnesota$67.11$9.097.4x47,964
Mississippi$66.54$8.817.6x3,011
Massachusetts$64.44$9.117.1x32,833
New Jersey$63.82$9.107.0x303,038
Wyoming$63.24$9.116.9x81
Pennsylvania$63.00$9.106.9x33,737
Colorado$62.26$9.096.9x31,307
North Carolina$61.70$9.106.8x181,048
Georgia$58.97$9.116.5x36,490
Nevada$57.61$9.076.4x21,577
California$57.49$9.106.3x232,436
Texas$57.06$9.106.3x172,347
Idaho$56.27$9.116.2x291
Arizona$54.59$9.086.0x107,888
Oregon$54.00$9.105.9x8,312
Indiana$53.02$9.105.8x7,965
Maryland$52.69$9.105.8x42,767
Oklahoma$52.65$9.095.8x12,273
Delaware$52.56$9.075.8x522
Connecticut$51.74$9.035.7x1,626
Florida$51.44$9.105.7x260,701
Alabama$50.79$9.095.6x65,578
Ohio$50.60$9.105.6x68,964
Washington$49.70$9.085.5x37,420
Louisiana$48.84$9.095.4x4,976
Virginia$47.37$9.085.2x46,363
South Dakota$47.23$9.055.2x3,379
Kentucky$40.09$9.064.4x4,461
North Dakota$36.94$9.084.1x1,003
Tennessee$35.87$9.093.9x52,054
Hawaii$35.38$9.093.9x5,156
Michigan$33.79$9.083.7x15,265
New Hampshire$31.65$9.113.5x941
Iowa$30.60$9.063.4x11,510
Utah$26.96$9.063.0x4,510
New Mexico$25.23$9.062.8x5,522
Maine$23.53$9.082.6x2,963
Arkansas$23.36$9.072.6x14,802
Nebraska$18.46$9.102.0x4,432
Rhode Island$18.09$9.082.0x2,505
Puerto Rico$10.40$9.071.1x750
Virgin Islands$9.28$9.051.0x393

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

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