Code 99239. Medicare covered 5,422,288 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Foreign Country billed the most for this, at $814.79. In Virgin Islands the average was $155.37. 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 |
|---|---|---|---|---|
| Foreign Country | $814.79 | $110.55 | 7.4x | 554 |
| Armed Forces Central/South America | $640.52 | $109.85 | 5.8x | 186 |
| Alaska | $610.41 | $143.10 | 4.3x | 8,258 |
| Wisconsin | $463.09 | $104.86 | 4.4x | 86,015 |
| Wyoming | $427.48 | $106.36 | 4.0x | 7,277 |
| Minnesota | $423.06 | $106.25 | 4.0x | 78,964 |
| New York | $414.82 | $118.11 | 3.5x | 275,306 |
| Maryland | $407.87 | $113.38 | 3.6x | 124,665 |
| California | $395.79 | $118.22 | 3.3x | 494,343 |
| New Hampshire | $390.80 | $110.21 | 3.5x | 32,265 |
| New Jersey | $389.69 | $118.03 | 3.3x | 183,392 |
| Puerto Rico | $386.75 | $109.24 | 3.5x | 2,062 |
| Washington | $383.20 | $112.55 | 3.4x | 83,531 |
| District of Columbia | $382.41 | $118.77 | 3.2x | 19,765 |
| Nevada | $376.37 | $109.25 | 3.4x | 67,408 |
| Texas | $373.57 | $108.60 | 3.4x | 403,503 |
| Montana | $372.13 | $108.56 | 3.4x | 19,455 |
| Northern Mariana Islands | $371.31 | $110.78 | 3.4x | 68 |
| Louisiana | $367.05 | $106.06 | 3.5x | 76,265 |
| Oregon | $366.25 | $110.44 | 3.3x | 49,121 |
| Virginia | $359.41 | $110.39 | 3.3x | 162,223 |
| Tennessee | $357.72 | $103.94 | 3.4x | 110,709 |
| New Mexico | $355.35 | $106.21 | 3.3x | 23,830 |
| Georgia | $353.60 | $108.04 | 3.3x | 157,096 |
| Guam | $353.55 | $110.66 | 3.2x | 955 |
| Florida | $353.00 | $111.54 | 3.2x | 467,332 |
| North Carolina | $351.74 | $105.43 | 3.3x | 163,960 |
| Ohio | $351.58 | $106.13 | 3.3x | 213,565 |
| Massachusetts | $346.58 | $114.08 | 3.0x | 169,744 |
| Utah | $345.53 | $105.80 | 3.3x | 22,558 |
| Kansas | $343.98 | $104.96 | 3.3x | 51,526 |
| Oklahoma | $342.54 | $105.49 | 3.2x | 75,384 |
| Michigan | $339.26 | $110.10 | 3.1x | 155,553 |
| North Dakota | $336.21 | $107.38 | 3.1x | 18,694 |
| Rhode Island | $336.11 | $112.21 | 3.0x | 17,421 |
| Idaho | $334.38 | $104.14 | 3.2x | 21,128 |
| Colorado | $333.08 | $110.64 | 3.0x | 66,317 |
| Illinois | $328.97 | $112.95 | 2.9x | 255,940 |
| Mississippi | $326.23 | $102.91 | 3.2x | 60,790 |
| Iowa | $325.43 | $103.40 | 3.1x | 45,379 |
| Connecticut | $320.11 | $115.95 | 2.8x | 59,905 |
| South Carolina | $312.64 | $106.08 | 2.9x | 97,114 |
| Vermont | $311.62 | $107.34 | 2.9x | 9,604 |
| Kentucky | $309.36 | $106.37 | 2.9x | 89,543 |
| West Virginia | $301.73 | $108.05 | 2.8x | 31,795 |
| Pennsylvania | $301.16 | $108.43 | 2.8x | 267,731 |
| Armed Forces Europe | $300.41 | $110.29 | 2.7x | 50 |
| Arizona | $297.30 | $108.16 | 2.7x | 125,584 |
| Missouri | $292.91 | $106.72 | 2.7x | 121,130 |
| Armed Forces Pacific | $286.00 | $123.17 | 2.3x | 211 |
| Maine | $284.99 | $108.64 | 2.6x | 23,312 |
| South Dakota | $283.62 | $105.99 | 2.7x | 14,475 |
| Hawaii | $282.72 | $112.82 | 2.5x | 13,779 |
| Nebraska | $282.26 | $103.96 | 2.7x | 33,357 |
| Alabama | $279.75 | $104.00 | 2.7x | 63,647 |
| Indiana | $273.44 | $104.96 | 2.6x | 120,302 |
| Delaware | $266.80 | $110.10 | 2.4x | 24,219 |
| Arkansas | $233.05 | $102.97 | 2.3x | 53,902 |
| $212.25 | $114.42 | 1.9x | 32 | |
| Virgin Islands | $155.37 | $106.51 | 1.5x | 37 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.