84100

Phosphate level

Code 84100. Medicare covered 1,797,226 of these. Here is what providers billed and what Medicare allowed, state by state.

$26.52Billed, national avg
$4.63Medicare allowed
5.7xBilled vs allowed
9.2xHighest vs lowest state

Providers in South Carolina billed the most for this, at $44.18. In Virgin Islands the average was $4.82. 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$44.18$4.639.5x19,874
Alaska$38.45$4.608.4x360
New York$38.14$4.648.2x171,262
Wisconsin$34.06$4.567.5x19,375
Kansas$31.40$4.646.8x22,052
North Carolina$30.79$4.646.6x113,510
Georgia$30.50$4.646.6x28,463
West Virginia$30.46$4.636.6x545
Colorado$29.53$4.636.4x8,464
North Dakota$29.26$4.646.3x1,093
New Jersey$29.06$4.626.3x243,313
Texas$28.52$4.646.2x137,154
Illinois$27.33$4.645.9x39,483
Minnesota$27.29$4.635.9x16,393
Alabama$26.58$4.625.8x40,258
Ohio$26.44$4.635.7x43,549
Florida$25.77$4.645.6x128,890
Massachusetts$25.57$4.655.5x39,770
Louisiana$24.94$4.625.4x12,604
New Hampshire$24.87$4.655.4x237
Wyoming$24.86$4.635.4x536
Washington$24.80$4.615.4x20,182
California$24.54$4.645.3x248,120
Maryland$24.02$4.635.2x24,830
Pennsylvania$23.56$4.645.1x27,630
Guam$23.40$4.525.2x111
Nevada$23.34$4.645.0x11,650
Connecticut$23.24$4.515.2x2,527
District of Columbia$22.86$4.634.9x430
Mississippi$22.25$4.614.8x5,923
Missouri$21.84$4.644.7x10,749
Tennessee$21.35$4.624.6x36,066
Indiana$19.86$4.624.3x6,674
South Dakota$19.82$4.644.3x4,436
Montana$19.51$4.644.2x639
Idaho$18.87$4.604.1x1,406
Oregon$18.69$4.614.1x7,261
New Mexico$18.61$4.614.0x6,526
Oklahoma$18.46$4.624.0x31,695
Arizona$18.15$4.623.9x141,442
Virginia$18.09$4.633.9x21,972
Rhode Island$17.99$4.643.9x1,720
Arkansas$16.76$4.623.6x33,622
Maine$16.60$4.613.6x2,215
Hawaii$14.71$4.513.3x7,667
Iowa$14.57$4.633.1x7,694
Kentucky$14.24$4.603.1x3,597
Michigan$13.34$4.632.9x29,134
Utah$12.12$4.632.6x3,400
Nebraska$11.86$4.612.6x8,087
Delaware$10.51$4.652.3x353
Puerto Rico$5.23$4.641.1x1,650
Virgin Islands$4.82$4.651.0x589

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

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