North Dakota

What Medicare pays in North Dakota

Billed charges against Medicare allowed amounts in North Dakota, across the 245 procedures Medicare covers most often.

245Procedures
3,577,194Services covered
3.2xBilled vs allowed
#26Rank of 61

Providers here billed the most above the national figure for detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique. The average was $142.69 against a national $58.61. That is 2.4 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 North Dakota

ProcedureBilled hereAllowedGapvs national billed
Ground mileage, per statute mile$25.29$9.912.6x0.96x
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$234.43$95.612.5x0.85x
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$168.42$68.682.5x0.89x
Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes$74.60$23.233.2x1.08x
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$2.63$1.112.4x1.51x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$226.81$73.543.1x1.12x
Therapy procedure using functional activities$83.88$30.152.8x1.13x
Chiropractic manipulative treatment, 3-4 spinal regions$71.18$38.141.9x1.17x
Therapy procedure using manual technique, each 15 minutes$67.60$20.803.3x1.00x
Fixed wing air mileage, per statute mile$107.29$14.147.6x0.77x
Pathology examination of tissue using a microscope, intermediate complexity$136.31$38.883.5x0.73x
Insertion of needle into vein for collection of blood sample$19.88$8.602.3x0.91x
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$47.35$15.183.1x1.09x
Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes$71.96$27.292.6x0.99x
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only$45.36$7.685.9x1.01x
Chiropractic manipulative treatment, 1-2 spinal regions$52.91$26.312.0x1.08x
Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg$3.23$0.734.4x1.37x
Injection, bupivacaine liposome, 1 mg$3.74$1.412.6x0.76x
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count$46.65$7.596.1x1.26x
Blood test, comprehensive group of blood chemicals$71.36$10.336.9x1.16x
Destruction of precancer skin growth, 2-14 growths$19.72$3.975.0x0.90x
Established patient complete exam of visual system$229.40$116.012.0x1.01x
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$308.39$135.152.3x0.76x
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$348.31$111.063.1x1.07x
Screening mammography$173.02$47.363.7x0.70x
Screening 3d breast mammography$78.78$26.213.0x0.57x
Administration of influenza virus vaccine$38.97$29.651.3x0.96x
Imaging of retina$106.73$35.313.0x0.86x
Blood test, lipids (cholesterol and triglycerides)$71.13$13.095.4x0.74x
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$319.04$134.812.4x0.78x
X-ray of chest, 1 view$53.38$8.126.6x1.02x
Hemoglobin a1c level$42.26$9.494.5x0.73x
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$596.73$162.843.7x1.05x
Admn sarscov2 vacc 1 dose$55.50$36.021.5x1.10x
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit$318.12$102.963.1x1.14x
Blood test, thyroid stimulating hormone (tsh)$64.19$16.433.9x0.67x
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$225.35$84.982.7x0.85x
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function$287.80$71.094.0x0.61x
Emergency department visit with high level of medical decision making$723.50$163.514.4x0.59x
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$128.88$45.412.8x1.07x

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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