Alabama

What Medicare pays in Alabama

Billed charges against Medicare allowed amounts in Alabama, across the 250 procedures Medicare covers most often.

250Procedures
25,109,947Services covered
3.1xBilled vs allowed
#28Rank of 61

Providers here billed the most above the national figure for identification of organisms by genetic analysis, amplified probe technique. The average was $130.83 against a national $64.75. That is 2.0 times as much.

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.

The 40 most common procedures in Alabama

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$17.38$9.671.8x0.66x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$198.29$108.591.8x0.72x
Insertion of needle into vein for collection of blood sample$19.03$8.422.3x0.87x
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled$1.27$1.111.1x0.73x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$139.21$76.941.8x0.74x
Blood test, comprehensive group of blood chemicals$43.29$10.324.2x0.70x
Rotary wing air mileage, per statute mile$458.12$37.9212.1x1.28x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$59.80$20.612.9x0.86x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$28.45$7.593.8x0.77x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$154.06$71.292.2x0.76x
Blood test, lipids (cholesterol and triglycerides)$75.56$13.075.8x0.79x
Therapy procedure using functional activities$63.41$28.942.2x0.85x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$57.36$24.342.4x0.79x
Blood test, thyroid stimulating hormone (tsh)$83.07$16.435.1x0.87x
Hemoglobin a1c level$49.41$9.475.2x0.85x
Therapy procedure using manual technique, each 15 minutes$50.51$18.772.7x0.75x
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's$27.98$14.851.9x0.64x
Removal of cataract with insertion of prosthetic lens$278.71$72.563.8x0.27x
Injection of drug or substance under skin or into muscle$38.86$12.063.2x0.70x
Destruction of precancer skin growth, 2-14 growths$29.42$5.485.4x1.34x
Pathology examination of tissue using a microscope, intermediate complexity$176.31$54.003.3x0.95x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$233.86$107.322.2x0.72x
Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care$35.54$7.954.5x0.91x
Fixed wing air mileage, per statute mile$239.80$13.8817.3x1.73x
X-ray of chest, 1 view$35.71$8.154.4x0.68x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$40.47$7.465.4x0.90x
Vitamin d-3 level$180.64$28.926.2x0.98x
Thyroxine (thyroid chemical), free$62.89$8.817.1x0.72x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$283.20$143.222.0x0.69x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report$55.61$12.434.5x0.81x
Creatinine level to test for kidney function or muscle injury$46.04$5.069.1x1.01x
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$87.38$56.541.5x0.77x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$203.17$114.551.8x0.73x
Cyanocobalamin (vitamin b-12) level$72.45$14.724.9x0.82x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$428.44$155.362.8x0.75x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$273.21$151.111.8x0.67x
Chiropractic manipulative treatment, 3-4 spinal regions$47.62$35.761.3x0.78x
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$193.88$88.252.2x0.92x
Urine microalbumin (protein) level$54.30$5.649.6x0.95x
Bacterial colony count, urine$46.34$7.905.9x0.91x

The last column compares this state against the national average for the same code. Above 1.00 means providers here billed more.

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

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