Code 99214. Medicare covered 103,737,268 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Alaska billed the most for this, at $387.32. In Northern Mariana Islands the average was $139.54. 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 |
|---|---|---|---|---|
| Alaska | $387.32 | $143.02 | 2.7x | 211,550 |
| New York | $372.07 | $131.43 | 2.8x | 6,278,716 |
| Massachusetts | $363.99 | $119.05 | 3.1x | 2,991,438 |
| Minnesota | $354.70 | $111.27 | 3.2x | 1,126,545 |
| Wisconsin | $345.01 | $107.00 | 3.2x | 1,276,531 |
| Oregon | $335.63 | $111.85 | 3.0x | 891,524 |
| California | $323.15 | $130.24 | 2.5x | 10,134,782 |
| New Jersey | $315.95 | $131.12 | 2.4x | 3,637,708 |
| Foreign Country | $296.63 | $107.19 | 2.8x | 1,780 |
| Washington | $293.22 | $118.65 | 2.5x | 1,777,424 |
| Nevada | $293.18 | $116.75 | 2.5x | 859,851 |
| Georgia | $288.98 | $116.23 | 2.5x | 3,095,998 |
| Colorado | $285.72 | $113.68 | 2.5x | 1,263,814 |
| Connecticut | $278.55 | $125.72 | 2.2x | 1,050,961 |
| Maryland | $278.40 | $120.18 | 2.3x | 3,033,381 |
| Nebraska | $277.38 | $105.00 | 2.6x | 677,352 |
| District of Columbia | $275.24 | $132.47 | 2.1x | 235,069 |
| Florida | $275.22 | $121.17 | 2.3x | 9,731,467 |
| Rhode Island | $274.58 | $114.18 | 2.4x | 294,992 |
| Wyoming | $267.37 | $114.63 | 2.3x | 155,466 |
| Texas | $267.36 | $116.86 | 2.3x | 7,355,781 |
| New Hampshire | $264.92 | $108.40 | 2.4x | 574,188 |
| Virgin Islands | $262.59 | $120.76 | 2.2x | 16,298 |
| Illinois | $262.15 | $119.51 | 2.2x | 3,869,301 |
| Arizona | $258.03 | $116.86 | 2.2x | 2,707,392 |
| Armed Forces Europe | $256.79 | $125.44 | 2.0x | 2,436 |
| Ohio | $256.40 | $105.78 | 2.4x | 3,373,828 |
| North Carolina | $255.11 | $111.33 | 2.3x | 3,547,141 |
| Utah | $251.01 | $111.99 | 2.2x | 652,239 |
| Armed Forces Pacific | $249.80 | $114.44 | 2.2x | 1,920 |
| Armed Forces Central/South America | $248.12 | $109.62 | 2.3x | 92 |
| Virginia | $246.22 | $117.51 | 2.1x | 3,404,659 |
| Tennessee | $242.68 | $109.02 | 2.2x | 2,574,882 |
| Pennsylvania | $239.91 | $116.36 | 2.1x | 4,331,911 |
| Iowa | $236.76 | $105.11 | 2.3x | 966,480 |
| Louisiana | $235.69 | $109.49 | 2.2x | 1,420,884 |
| Hawaii | $235.62 | $117.04 | 2.0x | 292,912 |
| North Dakota | $234.43 | $95.61 | 2.5x | 252,298 |
| Delaware | $233.58 | $116.62 | 2.0x | 586,243 |
| Maine | $233.11 | $96.42 | 2.4x | 291,821 |
| Montana | $231.45 | $102.25 | 2.3x | 333,721 |
| New Mexico | $231.06 | $107.11 | 2.2x | 485,901 |
| Kentucky | $230.14 | $108.37 | 2.1x | 1,412,729 |
| South Carolina | $227.37 | $113.68 | 2.0x | 2,519,299 |
| Missouri | $226.71 | $107.28 | 2.1x | 1,668,264 |
| Idaho | $226.35 | $99.46 | 2.3x | 420,434 |
| Oklahoma | $225.52 | $106.45 | 2.1x | 1,458,454 |
| West Virginia | $223.34 | $102.61 | 2.2x | 444,025 |
| Indiana | $219.81 | $111.28 | 2.0x | 2,176,450 |
| Kansas | $217.97 | $105.86 | 2.1x | 1,008,844 |
| Michigan | $207.57 | $111.54 | 1.9x | 2,323,546 |
| Unknown | $204.00 | $128.52 | 1.6x | 3,370 |
| Arkansas | $199.31 | $102.63 | 1.9x | 1,180,605 |
| Alabama | $198.29 | $108.59 | 1.8x | 1,592,343 |
| South Dakota | $193.64 | $98.92 | 2.0x | 286,410 |
| Mississippi | $191.82 | $105.98 | 1.8x | 1,245,123 |
| Vermont | $185.58 | $101.09 | 1.8x | 160,448 |
| Guam | $177.36 | $125.56 | 1.4x | 25,412 |
| Puerto Rico | $154.63 | $119.66 | 1.3x | 41,773 |
| Northern Mariana Islands | $139.54 | $109.75 | 1.3x | 1,059 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.