80048

Blood test, basic group of blood chemicals (calcium, total)

Code 80048. Medicare covered 5,135,813 of these. Here is what providers billed and what Medicare allowed, state by state.

$47.96Billed, national avg
$8.27Medicare allowed
5.8xBilled vs allowed
15.8xHighest vs lowest state

Providers in Armed Forces Pacific billed the most for this, at $145.00. In Virgin Islands the average was $9.15. Same procedure code, same programme.

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.

By state

StateBilledMedicare allowedGapServices
Armed Forces Pacific$145.00$8.2917.5x18
Wisconsin$92.05$8.2211.2x125,319
Alaska$90.44$8.2311.0x2,219
North Dakota$69.56$8.268.4x13,085
Kansas$62.88$8.287.6x116,324
Illinois$61.91$8.287.5x178,617
Arizona$57.58$8.287.0x116,194
Florida$56.34$8.286.8x385,736
California$55.95$8.286.8x480,923
Massachusetts$52.73$8.286.4x237,363
Georgia$52.54$8.266.4x101,863
Connecticut$52.52$8.286.3x16,181
Iowa$51.32$8.266.2x61,088
Montana$50.82$8.286.1x5,471
Pennsylvania$50.68$8.286.1x117,659
Texas$49.80$8.276.0x302,455
Missouri$49.76$8.276.0x38,373
Minnesota$49.05$8.255.9x144,026
South Dakota$48.99$8.265.9x23,256
Mississippi$48.41$8.225.9x56,870
Ohio$47.93$8.275.8x242,001
New York$47.38$8.285.7x179,867
New Jersey$45.28$8.245.5x501,886
Arkansas$45.22$8.265.5x47,334
South Carolina$44.13$8.245.4x124,301
Washington$43.66$8.265.3x95,841
Armed Forces Europe$43.20$8.165.3x51
Rhode Island$42.85$8.285.2x18,818
West Virginia$41.39$8.245.0x3,243
District of Columbia$41.35$8.255.0x346
North Carolina$41.24$8.285.0x346,877
Wyoming$40.82$8.274.9x4,456
Louisiana$39.36$8.264.8x44,407
Maryland$39.29$8.284.7x106,700
Guam$37.80$8.244.6x499
Colorado$37.57$8.264.5x52,525
Michigan$37.44$8.274.5x43,511
New Mexico$36.98$8.264.5x8,204
Hawaii$36.15$8.254.4x40,718
Vermont$35.40$8.284.3x1,712
Indiana$34.63$8.274.2x40,697
Alabama$34.59$8.264.2x111,427
Nevada$33.09$8.264.0x37,983
New Hampshire$32.89$8.284.0x8,402
Idaho$32.83$8.254.0x3,441
Oregon$32.06$8.263.9x43,410
Tennessee$29.61$8.253.6x165,265
Oklahoma$29.41$8.273.6x56,477
Virginia$28.99$8.263.5x168,839
Kentucky$28.56$8.263.5x37,052
Nebraska$24.80$8.273.0x28,052
Maine$23.94$8.272.9x13,342
Utah$20.78$8.272.5x19,478
Delaware$16.59$8.292.0x6,222
Puerto Rico$9.18$8.251.1x8,617
Virgin Islands$9.15$8.271.1x729

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

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