Minnesota

What Medicare pays in Minnesota

Billed charges against Medicare allowed amounts in Minnesota, across the 248 procedures Medicare covers most often.

248Procedures
16,787,412Services covered
3.9xBilled vs allowed
#6Rank of 61

Providers here billed the most above the national figure for identification of organisms by genetic analysis, amplified probe technique. The average was $170.42 against a national $64.75. That is 2.6 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 Minnesota

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$33.18$9.923.3x1.26x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$354.70$111.273.2x1.29x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$243.05$78.553.1x1.29x
Insertion of needle into vein for collection of blood sample$21.96$8.582.6x1.01x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$89.07$23.113.9x1.29x
Removal of cataract with insertion of prosthetic lens$192.47$48.254.0x0.19x
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$53.07$15.253.5x1.22x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$284.62$72.413.9x1.40x
X-ray of chest, 1 view$49.69$8.286.0x0.95x
Chiropractic manipulative treatment, 3-4 spinal regions$63.65$38.361.7x1.05x
Pathology examination of tissue using a microscope, intermediate complexity$178.40$42.024.2x0.96x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$92.19$27.373.4x1.27x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$432.35$109.883.9x1.33x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$511.05$156.453.3x1.26x
Therapy procedure using manual technique, each 15 minutes$78.11$20.463.8x1.15x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$65.62$7.768.5x1.47x
Therapy procedure using functional activities$87.91$31.262.8x1.18x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$49.16$7.586.5x1.32x
X-ray of chest, 2 views$71.00$14.984.7x0.99x
Ct scan head or brain without contrast$218.57$39.485.5x0.88x
Destruction of precancer skin growth, 2-14 growths$23.71$5.644.2x1.08x
Admn sarscov2 vacc 1 dose$43.66$35.241.2x0.86x
Administration of influenza virus vaccine$36.11$27.931.3x0.89x
Injection, bupivacaine liposome, 1 mg$4.66$1.393.4x0.95x
Psychotherapy, 1 hour$252.82$119.012.1x1.21x
Ct scan of abdomen and pelvis with contrast$617.25$107.475.7x1.00x
Blood test, comprehensive group of blood chemicals$67.97$10.316.6x1.11x
Blood test, basic group of blood chemicals (calcium, total)$49.05$8.255.9x1.02x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$502.25$150.393.3x1.23x
Screening mammography$242.78$63.193.8x0.98x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$392.32$122.013.2x1.41x
Screening 3d breast mammography$118.90$32.813.6x0.86x
Emergency department visit with high level of medical decision making$938.24$161.395.8x0.76x
Established patient complete exam of visual system$268.46$120.412.2x1.18x
Blood test, clotting time$24.13$4.195.8x0.88x
Hemoglobin a1c level$43.89$9.464.6x0.76x
Blood test, lipids (cholesterol and triglycerides)$65.45$13.045.0x0.68x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$331.29$98.943.3x1.25x
Imaging of retina$144.98$38.983.7x1.17x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$710.60$160.544.4x1.25x

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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