88342

Special stained specimen slides to examine tissue, initial procedure

Code 88342. Medicare covered 2,439,385 of these. Here is what providers billed and what Medicare allowed, state by state.

$192.62Billed, national avg
$58.58Medicare allowed
3.3xBilled vs allowed
3.6xHighest vs lowest state

Providers in Alaska billed the most for this, at $384.85. In Maine the average was $106.69. 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$384.85$46.158.3x1,993
Wisconsin$343.86$56.596.1x44,814
Wyoming$265.69$38.566.9x464
Texas$237.62$61.143.9x183,237
New York$227.78$62.143.7x184,596
Illinois$221.97$54.764.1x108,845
New Hampshire$215.35$44.374.9x12,734
Arizona$214.93$66.963.2x80,758
Mississippi$211.16$51.414.1x15,826
New Jersey$205.63$64.623.2x93,611
Rhode Island$202.82$41.694.9x5,617
Connecticut$199.30$67.043.0x28,614
Iowa$195.94$48.204.1x21,410
Maryland$195.46$76.152.6x96,577
Tennessee$191.53$64.423.0x72,753
Massachusetts$190.70$54.753.5x95,638
Kansas$189.20$51.163.7x28,627
Georgia$188.00$64.652.9x56,737
California$187.37$61.903.0x230,613
South Carolina$183.99$48.033.8x32,023
Oregon$182.03$48.423.8x19,844
Florida$181.31$65.312.8x242,726
Armed Forces Europe$181.00$34.855.2x19
Pennsylvania$175.73$53.113.3x112,353
Minnesota$175.48$50.053.5x35,169
Ohio$172.69$48.173.6x74,344
Armed Forces Pacific$170.33$55.533.1x67
West Virginia$168.29$41.124.1x8,644
District of Columbia$168.24$44.843.8x8,630
Hawaii$167.91$58.302.9x5,437
New Mexico$166.60$47.553.5x7,982
Michigan$165.66$39.874.2x36,813
Nevada$165.37$58.962.8x8,411
North Carolina$165.15$58.622.8x60,306
Delaware$164.52$54.293.0x12,937
Washington$163.35$59.912.7x41,461
Colorado$162.51$57.242.8x29,639
Missouri$161.22$52.163.1x41,302
Arkansas$160.64$70.072.3x47,150
Foreign Country$160.13$35.374.5x273
Indiana$158.30$44.553.6x36,590
Virginia$157.47$56.252.8x61,994
Utah$156.47$53.852.9x13,061
Alabama$151.33$62.482.4x24,110
North Dakota$150.30$39.313.8x12,564
Nebraska$149.23$39.013.8x12,698
Oklahoma$146.98$45.303.2x14,235
Vermont$144.27$34.424.2x3,942
Kentucky$140.12$39.413.6x20,768
Idaho$139.99$53.422.6x4,750
Louisiana$134.37$39.153.4x22,927
South Dakota$117.92$37.573.1x7,481
Puerto Rico$115.83$79.881.4x1,711
Montana$109.21$35.773.1x6,282
Maine$106.69$34.463.1x7,272

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

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