93018

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician

Code 93018. Medicare covered 883,429 of these. Here is what providers billed and what Medicare allowed, state by state.

$78.53Billed, national avg
$13.44Medicare allowed
5.8xBilled vs allowed
15.5xHighest vs lowest state

Providers in Alaska billed the most for this, at $219.80. In Guam the average was $14.15. 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$219.80$17.3112.7x1,305
Wisconsin$211.82$12.8816.4x17,540
New Hampshire$163.50$13.3012.3x8,012
Wyoming$157.37$12.9512.2x846
Foreign Country$129.50$13.359.7x20
Pennsylvania$124.34$13.359.3x42,042
Delaware$123.25$13.409.2x3,441
Illinois$117.68$13.698.6x47,525
Massachusetts$109.85$13.957.9x30,437
South Carolina$104.12$13.157.9x19,471
Mississippi$99.35$12.967.7x9,721
Connecticut$97.97$14.166.9x8,614
West Virginia$95.81$13.257.2x5,803
North Carolina$86.85$13.096.6x24,767
Vermont$86.73$13.196.6x2,115
Missouri$86.54$13.076.6x24,663
Minnesota$86.18$13.336.5x14,309
Maryland$85.70$13.726.2x8,116
Kansas$85.29$13.046.5x14,301
Iowa$85.22$12.896.6x11,698
North Dakota$84.59$13.236.4x3,657
District of Columbia$82.80$14.295.8x522
California$80.11$14.185.6x51,853
Oregon$78.59$13.535.8x6,405
Indiana$73.14$12.965.6x31,380
New York$72.60$14.375.1x38,633
Georgia$71.06$13.275.4x29,903
Arkansas$65.42$12.845.1x13,296
Tennessee$64.75$12.975.0x29,725
Alabama$64.46$12.905.0x12,042
New Jersey$62.74$14.624.3x35,082
Texas$62.54$13.314.7x48,024
Michigan$60.49$13.454.5x30,196
Ohio$58.13$13.134.4x43,809
Florida$57.23$13.464.3x44,991
Rhode Island$56.18$13.624.1x2,595
Oklahoma$56.17$13.014.3x19,452
Louisiana$53.46$13.154.1x11,680
Nevada$52.92$13.214.0x5,705
South Dakota$52.61$12.624.2x7,129
Maine$51.93$13.483.9x3,966
Colorado$51.46$13.513.8x12,296
Hawaii$51.31$13.393.8x2,129
Kentucky$51.20$13.133.9x19,029
Virginia$50.84$13.443.8x25,850
Nebraska$48.27$12.863.8x6,620
New Mexico$47.44$13.273.6x4,130
Washington$45.00$13.543.3x19,240
Arizona$44.95$13.303.4x12,787
Montana$44.61$13.013.4x3,484
Utah$38.94$13.123.0x7,108
Idaho$37.27$12.862.9x4,985
Puerto Rico$33.10$13.382.5x361
Guam$14.15$12.851.1x611

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

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