84481

Thyroid hormone, t3 measurement, free

Code 84481. Medicare covered 1,529,939 of these. Here is what providers billed and what Medicare allowed, state by state.

$145.94Billed, national avg
$16.56Medicare allowed
8.8xBilled vs allowed
13.3xHighest vs lowest state

Providers in Kansas billed the most for this, at $230.48. In Virgin Islands the average was $17.39. 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
Kansas$230.48$16.5913.9x30,215
Georgia$204.74$16.5712.4x37,921
New Jersey$185.34$16.5811.2x136,190
Colorado$184.57$16.5711.1x11,801
Alaska$183.55$16.6011.1x548
Nevada$181.46$16.5810.9x20,484
Washington$177.45$16.5810.7x17,360
Texas$168.59$16.5710.2x202,624
North Carolina$167.99$16.5810.1x105,314
Florida$166.02$16.5810.0x197,223
Illinois$165.12$16.5810.0x30,855
Ohio$162.02$16.589.8x43,401
Maryland$159.64$16.589.6x18,293
New Hampshire$149.22$16.609.0x26
Wisconsin$147.93$16.389.0x7,449
Massachusetts$141.53$16.598.5x22,975
Guam$141.30$16.598.5x29
Alabama$135.38$16.548.2x38,408
Arizona$133.82$16.578.1x99,024
California$132.25$16.568.0x208,369
South Dakota$114.72$16.546.9x1,145
Pennsylvania$107.23$16.576.5x13,969
New York$105.42$16.586.4x83,010
Minnesota$104.22$16.506.3x2,192
West Virginia$90.94$16.605.5x88
New Mexico$90.07$16.535.4x6,062
Oklahoma$81.86$16.425.0x19,189
Connecticut$80.82$16.604.9x114
South Carolina$79.26$16.524.8x15,585
Tennessee$78.31$16.504.7x47,466
Maine$76.83$16.604.6x151
Missouri$76.56$16.524.6x6,132
Wyoming$75.88$16.564.6x554
Hawaii$71.11$16.544.3x3,330
Montana$68.59$16.604.1x162
Louisiana$66.02$16.534.0x9,782
Vermont$65.57$16.484.0x106
Utah$65.28$16.514.0x6,155
Rhode Island$62.87$16.583.8x4,018
Iowa$61.79$16.513.7x1,334
Arkansas$61.50$16.513.7x6,998
Oregon$59.58$16.493.6x11,012
Indiana$59.06$16.523.6x5,565
Virginia$58.05$16.523.5x15,015
Mississippi$57.44$16.463.5x4,639
Idaho$53.90$16.543.3x2,998
Kentucky$52.63$16.543.2x7,920
Michigan$49.45$16.563.0x11,394
North Dakota$49.36$16.593.0x8,728
Nebraska$49.25$16.533.0x3,807
Delaware$29.08$16.601.8x219
Puerto Rico$18.03$16.481.1x1,836
Virgin Islands$17.39$16.601.0x731

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

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