84443

Blood test, thyroid stimulating hormone (tsh)

Code 84443. Medicare covered 13,899,335 of these. Here is what providers billed and what Medicare allowed, state by state.

$95.89Billed, national avg
$16.44Medicare allowed
5.8xBilled vs allowed
7.6xHighest vs lowest state

Providers in Alaska billed the most for this, at $137.88. In Puerto Rico the average was $18.05. 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
Alaska$137.88$16.408.4x6,871
Kansas$124.27$16.457.6x363,718
Wisconsin$120.47$16.377.4x126,734
Georgia$117.87$16.447.2x385,346
New Jersey$116.40$16.457.1x1,645,787
Massachusetts$114.44$16.457.0x319,907
Illinois$112.33$16.456.8x364,548
Nevada$110.83$16.456.7x112,226
Florida$103.85$16.456.3x1,538,134
Pennsylvania$103.22$16.456.3x224,170
New York$103.10$16.456.3x664,849
California$102.72$16.456.2x1,477,488
Maryland$99.21$16.446.0x231,331
West Virginia$98.30$16.406.0x12,150
Colorado$97.29$16.435.9x116,825
Texas$96.47$16.445.9x1,329,793
North Carolina$96.17$16.455.8x1,079,050
Guam$90.90$16.345.6x275
Washington$84.10$16.435.1x221,325
Alabama$83.07$16.435.1x411,098
Minnesota$82.89$16.415.1x82,374
Vermont$82.43$16.445.0x1,296
Montana$82.28$16.445.0x11,587
Arizona$82.10$16.455.0x523,933
South Carolina$81.04$16.375.0x126,469
Missouri$80.74$16.434.9x73,233
Ohio$76.49$16.444.7x507,703
Mississippi$72.55$16.384.4x74,291
South Dakota$71.87$16.424.4x22,212
District of Columbia$71.06$16.454.3x1,501
New Mexico$70.73$16.424.3x45,101
Wyoming$69.04$16.424.2x8,785
Unknown$69.00$16.464.2x51
Connecticut$68.60$16.434.2x20,964
Oklahoma$67.10$16.444.1x151,018
Tennessee$65.61$16.434.0x449,766
North Dakota$64.19$16.433.9x21,952
Louisiana$63.59$16.443.9x95,786
Oregon$63.20$16.423.8x102,428
Kentucky$60.54$16.433.7x85,744
New Hampshire$60.49$16.443.7x7,838
Arkansas$59.42$16.413.6x75,082
Iowa$59.28$16.423.6x63,514
Hawaii$59.26$16.433.6x57,290
Armed Forces Central/South America$57.00$16.463.5x12
Idaho$55.44$16.413.4x12,840
Armed Forces Europe$54.47$16.233.4x55
Indiana$54.30$16.443.3x91,292
Maine$53.45$16.423.3x15,890
Virginia$51.84$16.343.2x275,302
Rhode Island$50.22$16.453.1x20,385
Michigan$46.23$16.442.8x110,058
Utah$45.06$16.432.7x46,988
Nebraska$43.57$16.432.7x45,451
Delaware$27.11$16.461.6x2,900
Virgin Islands$18.71$16.421.1x3,634
Puerto Rico$18.05$16.351.1x32,915

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

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