93970

Ultrasound study of arm or leg veins with compression and maneuvers

Code 93970. Medicare covered 1,435,694 of these. Here is what providers billed and what Medicare allowed, state by state.

$351.16Billed, national avg
$96.10Medicare allowed
3.7xBilled vs allowed
4.1xHighest vs lowest state

Providers in Alaska billed the most for this, at $665.19. In Vermont the average was $160.60. 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$665.19$104.186.4x1,080
New Jersey$497.27$102.754.8x71,266
Wisconsin$469.82$53.378.8x10,821
New York$463.07$119.743.9x144,886
Armed Forces Central/South America$422.97$31.4813.4x63
Connecticut$419.14$98.214.3x17,654
Arizona$417.82$127.773.3x41,369
Hawaii$417.03$115.113.6x3,247
Delaware$414.92$77.345.4x4,390
Illinois$407.08$82.654.9x66,854
Texas$403.21$109.093.7x94,095
Nevada$385.39$98.453.9x16,414
District of Columbia$382.80$116.833.3x5,941
Georgia$369.12$85.884.3x41,590
New Mexico$366.06$91.834.0x6,398
California$365.64$125.382.9x216,234
Wyoming$359.18$85.364.2x1,227
Florida$352.64$110.643.2x130,262
Montana$351.15$93.253.8x2,566
Colorado$349.45$94.583.7x15,323
Virgin Islands$335.09$127.732.6x64
South Carolina$323.04$74.234.4x18,878
Tennessee$321.21$83.393.9x28,851
Rhode Island$319.93$78.094.1x2,971
Utah$318.17$80.364.0x5,142
Louisiana$315.94$92.533.4x15,948
Virginia$310.34$81.823.8x35,861
North Carolina$304.52$74.974.1x36,366
Armed Forces Pacific$302.90$64.394.7x91
Maryland$300.26$108.302.8x45,038
Mississippi$299.40$76.123.9x10,782
Minnesota$292.37$57.945.0x20,389
Iowa$286.52$67.784.2x7,080
Massachusetts$267.95$58.154.6x24,756
Michigan$261.36$78.333.3x37,562
Maine$259.88$75.933.4x2,750
Pennsylvania$257.24$65.084.0x51,396
Indiana$253.65$65.993.8x17,347
Kansas$244.24$66.463.7x8,924
West Virginia$240.40$52.674.6x6,175
Arkansas$237.84$67.503.5x9,624
North Dakota$237.02$40.375.9x2,508
Oregon$232.02$63.253.7x7,497
Missouri$230.32$58.703.9x22,523
New Hampshire$229.95$43.215.3x3,185
Washington$229.58$70.443.3x17,571
Unknown$222.10$166.141.3x566
Ohio$221.28$54.874.0x38,971
South Dakota$220.85$62.863.5x3,528
Idaho$220.64$49.084.5x3,477
Kentucky$213.09$60.633.5x12,450
Puerto Rico$201.90$141.121.4x1,992
Alabama$200.32$71.272.8x23,968
Nebraska$194.25$52.623.7x6,648
Guam$188.34$143.941.3x322
Oklahoma$178.94$51.603.5x11,740
Vermont$160.60$39.194.1x1,061

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

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