93880

Ultrasound of both sides of head and neck blood flow

Code 93880. Medicare covered 1,671,936 of these. Here is what providers billed and what Medicare allowed, state by state.

$414.04Billed, national avg
$123.22Medicare allowed
3.4xBilled vs allowed
5.5xHighest vs lowest state

Providers in Alaska billed the most for this, at $892.02. In Vermont the average was $163.53. 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$892.02$131.216.8x2,494
Wyoming$683.22$113.196.0x1,969
Wisconsin$647.63$63.4610.2x14,855
New York$643.08$177.043.6x177,198
Connecticut$485.65$128.903.8x13,272
New Jersey$481.96$155.253.1x72,169
Illinois$461.57$99.894.6x54,141
Arizona$451.41$150.043.0x46,156
Texas$449.64$127.763.5x124,284
South Carolina$449.26$104.944.3x36,618
Rhode Island$444.17$113.973.9x4,338
California$442.26$166.002.7x201,829
Hawaii$436.05$136.443.2x3,799
Nevada$434.78$138.933.1x18,029
Louisiana$431.74$120.303.6x32,783
Georgia$419.11$105.854.0x51,479
Delaware$414.47$139.563.0x11,076
District of Columbia$413.92$162.552.5x4,422
Mississippi$408.01$92.064.4x18,226
Maryland$403.15$158.442.5x48,570
North Carolina$397.08$102.373.9x44,835
Armed Forces Central/South America$397.00$36.2810.9x38
Florida$393.64$136.132.9x150,561
Armed Forces Pacific$388.73$94.204.1x67
Minnesota$382.03$77.404.9x14,769
Massachusetts$378.56$89.684.2x32,728
Virgin Islands$353.80$176.612.0x83
Virginia$343.67$102.433.4x42,251
Washington$341.48$112.143.0x18,650
Utah$341.30$93.653.6x3,842
Colorado$340.63$98.073.5x11,000
Tennessee$331.64$92.543.6x40,215
Oregon$329.41$94.123.5x9,067
New Mexico$320.06$72.714.4x3,834
Pennsylvania$316.25$91.293.5x58,965
Kansas$307.02$78.773.9x15,801
Michigan$301.52$101.733.0x37,598
West Virginia$294.03$68.724.3x11,217
Iowa$281.99$67.884.2x12,979
Alabama$277.48$102.582.7x29,423
Idaho$275.55$60.084.6x5,231
Montana$272.63$84.923.2x3,404
Indiana$264.98$71.723.7x23,190
New Hampshire$259.49$56.944.6x6,472
Arkansas$256.70$64.584.0x18,723
North Dakota$253.11$48.885.2x4,452
Missouri$250.79$63.364.0x24,495
Nebraska$245.87$61.094.0x9,389
Maine$243.96$68.103.6x4,093
South Dakota$233.08$64.203.6x5,691
Unknown$232.60$201.251.2x643
Oklahoma$229.74$73.403.1x24,256
Ohio$229.46$60.563.8x43,167
Guam$218.64$175.341.2x207
Puerto Rico$207.86$149.571.4x2,766
Kentucky$206.21$66.513.1x18,621
Vermont$163.53$45.903.6x1,486

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

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