84403

Testosterone (hormone) level, total

Code 84403. Medicare covered 1,288,334 of these. Here is what providers billed and what Medicare allowed, state by state.

$148.21Billed, national avg
$25.19Medicare allowed
5.9xBilled vs allowed
7.5xHighest vs lowest state

Providers in Nevada billed the most for this, at $193.11. In Virgin Islands the average was $25.89. 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$193.11$25.177.7x9,731
Kansas$184.02$25.277.3x26,562
Illinois$182.28$25.247.2x19,821
Georgia$182.27$25.237.2x35,685
Minnesota$174.73$25.216.9x10,658
Florida$174.22$25.276.9x157,624
Alaska$166.70$23.947.0x135
New Jersey$164.60$25.256.5x108,166
Colorado$162.77$25.276.4x15,009
North Carolina$160.89$25.256.4x90,393
Ohio$157.69$25.246.2x42,437
Arizona$152.81$25.236.1x65,327
New York$150.22$25.226.0x49,869
Texas$148.18$25.225.9x172,186
Massachusetts$146.91$25.265.8x26,487
California$145.88$25.135.8x182,582
Washington$144.99$25.265.7x19,549
Maryland$133.51$25.245.3x14,465
Wisconsin$132.07$24.715.3x4,460
Alabama$130.47$25.135.2x40,453
Pennsylvania$128.06$25.245.1x12,759
Connecticut$127.75$25.025.1x341
Missouri$120.84$25.224.8x3,882
Oklahoma$115.68$25.204.6x18,736
Kentucky$114.23$25.024.6x2,958
Arkansas$113.95$25.054.5x9,805
South Dakota$109.68$25.134.4x1,158
Hawaii$107.09$25.134.3x4,443
Wyoming$105.20$25.194.2x336
Tennessee$104.82$25.114.2x51,970
West Virginia$99.00$25.014.0x301
South Carolina$98.15$25.083.9x9,328
Mississippi$93.65$24.893.8x5,780
Iowa$92.25$24.933.7x2,023
Indiana$90.35$25.113.6x6,042
Louisiana$89.38$25.163.6x9,167
New Hampshire$87.20$25.293.4x361
Nebraska$83.65$25.193.3x6,041
Oregon$81.57$25.103.2x10,178
New Mexico$78.55$25.063.1x3,452
Rhode Island$78.04$25.253.1x729
Michigan$77.01$25.103.1x7,365
Montana$75.94$25.153.0x268
Idaho$73.57$25.112.9x2,071
Virginia$70.52$24.112.9x14,352
North Dakota$68.36$25.292.7x3,049
Maine$63.41$25.272.5x1,370
Utah$60.58$25.102.4x6,339
Vermont$56.00$25.292.2x27
Puerto Rico$27.28$25.191.1x1,865
Virgin Islands$25.89$25.121.0x222

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

← All procedures