Code 99454. Medicare covered 2,172,131 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in New York billed the most for this, at $199.07. In Virgin Islands the average was $82.50. 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 |
|---|---|---|---|---|
| New York | $199.07 | $51.69 | 3.9x | 167,724 |
| Wisconsin | $172.44 | $42.95 | 4.0x | 3,898 |
| Oregon | $171.12 | $46.97 | 3.6x | 11,586 |
| North Dakota | $166.44 | $41.15 | 4.0x | 354 |
| District of Columbia | $152.40 | $54.25 | 2.8x | 4,662 |
| Louisiana | $150.30 | $40.07 | 3.8x | 24,134 |
| Montana | $145.74 | $45.29 | 3.2x | 1,222 |
| Massachusetts | $145.58 | $49.17 | 3.0x | 17,303 |
| Michigan | $141.09 | $45.97 | 3.1x | 37,057 |
| New Jersey | $138.51 | $52.85 | 2.6x | 92,801 |
| Tennessee | $136.46 | $41.16 | 3.3x | 58,002 |
| Nevada | $135.97 | $46.30 | 2.9x | 25,781 |
| Maine | $135.78 | $44.74 | 3.0x | 806 |
| Iowa | $133.65 | $40.90 | 3.3x | 33,376 |
| Illinois | $132.14 | $46.99 | 2.8x | 63,686 |
| Virginia | $131.57 | $46.78 | 2.8x | 100,867 |
| California | $131.01 | $54.89 | 2.4x | 432,751 |
| South Carolina | $130.03 | $42.23 | 3.1x | 40,641 |
| Vermont | $129.51 | $43.08 | 3.0x | 39 |
| West Virginia | $128.36 | $41.32 | 3.1x | 1,673 |
| Arizona | $127.49 | $45.00 | 2.8x | 96,894 |
| Connecticut | $127.48 | $49.45 | 2.6x | 68,611 |
| Arkansas | $127.28 | $39.08 | 3.3x | 16,292 |
| Washington | $126.45 | $47.32 | 2.7x | 18,678 |
| Maryland | $126.31 | $53.78 | 2.3x | 75,445 |
| Texas | $124.80 | $44.91 | 2.8x | 197,177 |
| Georgia | $121.92 | $42.47 | 2.9x | 90,938 |
| North Carolina | $120.39 | $42.59 | 2.8x | 29,506 |
| New Mexico | $118.97 | $41.39 | 2.9x | 10,695 |
| Wyoming | $118.28 | $44.46 | 2.7x | 1,261 |
| Indiana | $115.83 | $41.89 | 2.8x | 17,274 |
| Missouri | $115.09 | $44.06 | 2.6x | 36,187 |
| Pennsylvania | $114.25 | $45.69 | 2.5x | 26,110 |
| Idaho | $110.87 | $41.05 | 2.7x | 5,117 |
| Minnesota | $109.36 | $44.76 | 2.4x | 5,656 |
| Rhode Island | $106.65 | $40.30 | 2.6x | 139 |
| Hawaii | $105.95 | $51.27 | 2.1x | 5,023 |
| Kansas | $105.22 | $42.37 | 2.5x | 14,244 |
| Ohio | $103.38 | $41.96 | 2.5x | 18,020 |
| Alabama | $103.03 | $40.02 | 2.6x | 33,432 |
| Utah | $99.83 | $42.31 | 2.4x | 12,794 |
| Alaska | $99.76 | $49.60 | 2.0x | 2,485 |
| Florida | $99.67 | $45.24 | 2.2x | 185,045 |
| South Dakota | $98.63 | $43.22 | 2.3x | 1,816 |
| Kentucky | $94.86 | $40.62 | 2.3x | 9,641 |
| Colorado | $94.29 | $48.36 | 1.9x | 12,521 |
| Oklahoma | $94.24 | $41.11 | 2.3x | 20,003 |
| Delaware | $93.64 | $45.70 | 2.0x | 9,138 |
| Mississippi | $93.31 | $39.34 | 2.4x | 18,914 |
| New Hampshire | $91.81 | $42.64 | 2.2x | 3,834 |
| Nebraska | $85.67 | $42.33 | 2.0x | 9,914 |
| Virgin Islands | $82.50 | $45.94 | 1.8x | 781 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.