84156

Total protein level, urine

Code 84156. Medicare covered 1,375,147 of these. Here is what providers billed and what Medicare allowed, state by state.

$34.15Billed, national avg
$3.59Medicare allowed
9.5xBilled vs allowed
17.9xHighest vs lowest state

Providers in New York billed the most for this, at $65.69. In Virgin Islands the average was $3.68. 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
New York$65.69$3.5918.3x38,081
Pennsylvania$49.91$3.6013.9x14,315
Kansas$45.15$3.6012.6x35,819
Illinois$44.23$3.5912.3x30,256
Nevada$43.97$3.6012.2x12,906
Wyoming$41.80$3.5911.6x39
Florida$41.56$3.6011.6x121,035
Texas$41.50$3.6011.5x145,548
Maryland$39.29$3.6010.9x15,971
Wisconsin$39.20$3.5211.1x13,556
New Jersey$38.69$3.6010.8x138,053
Colorado$38.06$3.5910.6x8,816
Georgia$37.55$3.5910.5x51,944
California$37.08$3.6010.3x144,428
Washington$35.76$3.5910.0x22,036
Massachusetts$35.50$3.609.9x24,963
North Carolina$33.39$3.609.3x120,810
North Dakota$33.21$3.559.4x750
Oklahoma$32.27$3.589.0x24,712
Mississippi$31.66$3.588.9x4,275
South Dakota$31.62$3.598.8x3,186
Alabama$31.28$3.598.7x45,240
Ohio$29.45$3.598.2x39,559
Indiana$25.54$3.597.1x5,222
Minnesota$24.55$3.586.9x11,404
Iowa$23.77$3.586.6x5,717
Alaska$22.84$3.576.4x1,674
Oregon$21.49$3.596.0x8,851
Maine$20.99$3.585.9x3,123
Tennessee$20.98$3.595.8x42,939
Nebraska$20.93$3.595.8x3,432
South Carolina$20.77$3.575.8x15,117
Louisiana$20.47$3.595.7x7,967
Montana$19.81$3.605.5x236
Rhode Island$19.00$3.595.3x423
Hawaii$18.57$3.595.2x9,497
Kentucky$17.30$3.554.9x2,191
New Mexico$17.26$3.594.8x5,391
Arizona$16.20$3.604.5x147,453
Virginia$16.00$3.584.5x12,769
Michigan$15.75$3.584.4x5,539
Missouri$15.22$3.604.2x10,406
District of Columbia$14.73$3.574.1x98
West Virginia$13.87$3.543.9x717
Connecticut$12.91$3.603.6x2,092
Idaho$12.17$3.593.4x2,602
Arkansas$11.68$3.583.3x4,810
New Hampshire$11.37$3.593.2x285
Delaware$10.96$3.583.1x4,157
Utah$10.29$3.592.9x1,952
Puerto Rico$3.89$3.541.1x2,298
Virgin Islands$3.68$3.601.0x463

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

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