Code 92004. Medicare covered 1,591,405 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Virgin Islands billed the most for this, at $448.56. In Armed Forces Pacific the average was $145.00. Same procedure code, same programme.
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.
| State | Billed | Medicare allowed | Gap | Services |
|---|---|---|---|---|
| Virgin Islands | $448.56 | $145.66 | 3.1x | 282 |
| Alaska | $328.03 | $168.17 | 2.0x | 3,184 |
| District of Columbia | $325.71 | $154.70 | 2.1x | 1,468 |
| Massachusetts | $322.11 | $150.11 | 2.1x | 54,084 |
| Minnesota | $318.97 | $141.91 | 2.2x | 23,178 |
| New York | $309.72 | $158.87 | 1.9x | 134,571 |
| Maryland | $285.02 | $153.50 | 1.9x | 33,434 |
| Wisconsin | $283.72 | $132.24 | 2.1x | 23,766 |
| Connecticut | $282.82 | $154.44 | 1.8x | 18,799 |
| Foreign Country | $281.44 | $140.05 | 2.0x | 116 |
| Oregon | $279.19 | $145.29 | 1.9x | 17,410 |
| Iowa | $276.79 | $135.05 | 2.0x | 18,561 |
| California | $275.91 | $159.36 | 1.7x | 164,346 |
| Georgia | $271.94 | $139.77 | 1.9x | 41,885 |
| Nevada | $269.13 | $143.47 | 1.9x | 12,689 |
| New Hampshire | $268.69 | $146.24 | 1.8x | 9,225 |
| New Jersey | $266.76 | $159.72 | 1.7x | 63,586 |
| North Dakota | $261.53 | $132.72 | 2.0x | 5,446 |
| Nebraska | $255.78 | $135.59 | 1.9x | 11,893 |
| Illinois | $254.59 | $144.36 | 1.8x | 63,269 |
| Washington | $254.03 | $148.71 | 1.7x | 33,712 |
| Texas | $252.25 | $141.54 | 1.8x | 127,256 |
| Colorado | $250.62 | $145.14 | 1.7x | 25,063 |
| Rhode Island | $248.74 | $148.44 | 1.7x | 5,011 |
| Utah | $247.18 | $134.01 | 1.8x | 12,531 |
| Florida | $247.10 | $142.94 | 1.7x | 134,937 |
| Ohio | $245.17 | $132.38 | 1.9x | 38,483 |
| Arizona | $244.38 | $143.01 | 1.7x | 36,642 |
| Hawaii | $239.88 | $153.29 | 1.6x | 4,360 |
| South Carolina | $239.80 | $137.74 | 1.7x | 26,670 |
| Virginia | $239.72 | $145.59 | 1.6x | 39,510 |
| Vermont | $237.99 | $139.13 | 1.7x | 6,148 |
| New Mexico | $234.94 | $136.12 | 1.7x | 12,005 |
| Pennsylvania | $231.57 | $142.79 | 1.6x | 55,081 |
| Idaho | $228.98 | $137.40 | 1.7x | 10,085 |
| Northern Mariana Islands | $228.77 | $158.16 | 1.4x | 133 |
| Tennessee | $228.69 | $136.38 | 1.7x | 32,787 |
| Louisiana | $225.13 | $132.80 | 1.7x | 22,258 |
| Arkansas | $224.34 | $131.27 | 1.7x | 19,766 |
| South Dakota | $219.60 | $140.75 | 1.6x | 8,558 |
| Missouri | $219.26 | $136.34 | 1.6x | 26,063 |
| North Carolina | $216.58 | $138.76 | 1.6x | 29,116 |
| Guam | $216.21 | $154.23 | 1.4x | 416 |
| West Virginia | $213.19 | $132.69 | 1.6x | 7,097 |
| Delaware | $212.51 | $146.14 | 1.5x | 4,815 |
| Oklahoma | $210.05 | $133.46 | 1.6x | 22,883 |
| Michigan | $206.67 | $138.65 | 1.5x | 31,344 |
| Kansas | $206.09 | $136.27 | 1.5x | 20,697 |
| Maine | $200.18 | $139.47 | 1.4x | 7,707 |
| Armed Forces Central/South America | $197.69 | $138.58 | 1.4x | 114 |
| Montana | $195.22 | $143.32 | 1.4x | 7,305 |
| Mississippi | $194.63 | $131.38 | 1.5x | 21,854 |
| Alabama | $189.27 | $132.85 | 1.4x | 14,364 |
| Kentucky | $186.08 | $133.04 | 1.4x | 16,024 |
| Wyoming | $180.43 | $143.33 | 1.3x | 3,848 |
| Indiana | $175.59 | $136.88 | 1.3x | 22,958 |
| Puerto Rico | $166.45 | $144.27 | 1.2x | 2,549 |
| Armed Forces Pacific | $145.00 | $137.26 | 1.1x | 46 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.