95024

Test for allergy using allergenic extract injected into skin

Code 95024. Medicare covered 1,338,236 of these. Here is what providers billed and what Medicare allowed, state by state.

$19.11Billed, national avg
$7.53Medicare allowed
2.5xBilled vs allowed
4.6xHighest vs lowest state

Providers in Nebraska billed the most for this, at $42.25. In Puerto Rico the average was $9.09. 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
Nebraska$42.25$6.976.1x1,774
Alaska$38.46$8.014.8x754
Massachusetts$33.23$7.984.2x55,288
North Dakota$27.90$6.264.5x1,003
Minnesota$26.34$6.953.8x2,836
Wisconsin$26.14$6.813.8x9,153
Oregon$25.65$7.663.4x9,967
Connecticut$25.65$8.383.1x9,596
Georgia$24.81$7.223.4x41,492
South Dakota$24.65$7.223.4x4,315
Wyoming$23.05$7.383.1x1,751
Louisiana$21.53$6.923.1x17,721
Illinois$21.04$7.832.7x29,491
Missouri$20.93$7.023.0x18,669
New Mexico$20.92$7.073.0x3,309
North Carolina$20.40$7.042.9x43,773
Delaware$20.29$7.682.6x21,214
Maryland$20.23$8.192.5x23,764
Montana$19.53$7.292.7x1,036
Colorado$19.22$7.792.5x11,106
District of Columbia$19.04$8.172.3x909
Florida$19.02$7.752.5x234,822
Kentucky$18.89$6.862.8x42,512
Indiana$18.73$6.922.7x31,987
New York$18.69$8.742.1x49,457
West Virginia$18.24$6.542.8x9,486
California$18.10$8.602.1x90,900
New Jersey$18.04$8.882.0x28,874
Texas$17.95$7.412.4x161,629
Tennessee$17.94$6.622.7x45,607
Rhode Island$17.73$7.882.3x4,145
New Hampshire$17.73$8.092.2x1,728
Idaho$17.44$6.782.6x4,026
Arkansas$17.41$6.662.6x11,269
Washington$17.10$7.222.4x18,465
South Carolina$16.98$7.052.4x38,239
Michigan$16.59$7.552.2x27,597
Nevada$16.35$7.512.2x4,489
Iowa$15.95$6.492.5x10,839
Arizona$15.87$7.552.1x18,742
Utah$15.85$7.072.2x3,774
Oklahoma$15.82$6.712.4x13,599
Maine$15.75$6.512.4x3,758
Vermont$15.66$7.162.2x490
Alabama$15.62$6.492.4x11,193
Ohio$15.56$6.432.4x25,541
Mississippi$15.36$6.232.5x7,857
Pennsylvania$14.95$7.412.0x50,394
Virginia$14.49$7.651.9x65,328
Kansas$14.23$6.692.1x9,573
Hawaii$11.45$8.671.3x897
Puerto Rico$9.09$7.851.2x835

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

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