Code 80053. Medicare covered 27,220,202 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Armed Forces Pacific billed the most for this, at $241.38. In Puerto Rico the average was $11.45. 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 |
|---|---|---|---|---|
| Armed Forces Pacific | $241.38 | $10.35 | 23.3x | 16 |
| Wisconsin | $103.30 | $10.26 | 10.1x | 279,629 |
| Alaska | $103.18 | $10.25 | 10.1x | 27,412 |
| Georgia | $81.59 | $10.33 | 7.9x | 730,299 |
| New York | $81.43 | $10.34 | 7.9x | 1,226,465 |
| Kansas | $80.02 | $10.34 | 7.7x | 613,930 |
| Massachusetts | $77.95 | $10.35 | 7.5x | 515,534 |
| Illinois | $77.95 | $10.33 | 7.5x | 752,517 |
| West Virginia | $74.32 | $10.30 | 7.2x | 23,333 |
| Pennsylvania | $71.47 | $10.34 | 6.9x | 463,872 |
| North Dakota | $71.36 | $10.33 | 6.9x | 46,288 |
| Florida | $70.61 | $10.34 | 6.8x | 2,957,677 |
| Mississippi | $68.25 | $10.26 | 6.7x | 187,124 |
| Nevada | $68.05 | $10.32 | 6.6x | 238,227 |
| Minnesota | $67.97 | $10.31 | 6.6x | 152,386 |
| Missouri | $66.63 | $10.33 | 6.4x | 199,639 |
| South Carolina | $66.11 | $10.27 | 6.4x | 207,591 |
| California | $65.96 | $10.34 | 6.4x | 2,782,689 |
| Texas | $64.30 | $10.33 | 6.2x | 2,723,467 |
| Montana | $64.12 | $10.33 | 6.2x | 23,682 |
| New Jersey | $63.59 | $10.33 | 6.2x | 2,974,496 |
| Maryland | $61.80 | $10.34 | 6.0x | 554,545 |
| Wyoming | $58.73 | $10.32 | 5.7x | 20,070 |
| District of Columbia | $56.16 | $10.33 | 5.4x | 6,973 |
| Rhode Island | $55.90 | $10.34 | 5.4x | 27,921 |
| Arizona | $54.72 | $10.34 | 5.3x | 1,064,880 |
| Connecticut | $52.54 | $10.32 | 5.1x | 53,292 |
| Vermont | $51.78 | $10.35 | 5.0x | 4,174 |
| Washington | $51.57 | $10.32 | 5.0x | 464,506 |
| South Dakota | $50.76 | $10.33 | 4.9x | 51,799 |
| Louisiana | $50.46 | $10.32 | 4.9x | 204,397 |
| Colorado | $50.42 | $10.32 | 4.9x | 239,552 |
| Iowa | $50.05 | $10.31 | 4.9x | 138,585 |
| Ohio | $49.98 | $10.32 | 4.8x | 967,056 |
| North Carolina | $49.68 | $10.33 | 4.8x | 2,025,946 |
| Indiana | $46.83 | $10.32 | 4.5x | 174,105 |
| New Mexico | $45.64 | $10.31 | 4.4x | 98,445 |
| Idaho | $45.32 | $10.30 | 4.4x | 32,989 |
| Arkansas | $45.01 | $10.30 | 4.4x | 213,832 |
| Guam | $44.04 | $10.18 | 4.3x | 1,197 |
| Alabama | $43.29 | $10.32 | 4.2x | 850,838 |
| Hawaii | $42.09 | $10.32 | 4.1x | 137,092 |
| New Hampshire | $41.88 | $10.33 | 4.1x | 12,021 |
| Virginia | $41.60 | $10.32 | 4.0x | 598,874 |
| Oregon | $40.78 | $10.32 | 4.0x | 218,806 |
| Unknown | $40.00 | $9.96 | 4.0x | 75 |
| Armed Forces Europe | $39.96 | $10.35 | 3.9x | 62 |
| Oklahoma | $38.50 | $10.33 | 3.7x | 343,163 |
| Armed Forces Central/South America | $37.00 | $10.35 | 3.6x | 14 |
| Kentucky | $36.03 | $10.32 | 3.5x | 149,932 |
| Nebraska | $35.53 | $10.32 | 3.4x | 119,669 |
| Michigan | $34.51 | $10.32 | 3.3x | 191,002 |
| Tennessee | $34.02 | $10.31 | 3.3x | 915,981 |
| Utah | $32.93 | $10.32 | 3.2x | 107,159 |
| Foreign Country | $30.00 | $10.35 | 2.9x | 12 |
| Maine | $29.57 | $10.32 | 2.9x | 45,358 |
| Delaware | $27.54 | $10.35 | 2.7x | 8,814 |
| Virgin Islands | $13.56 | $10.35 | 1.3x | 7,052 |
| Puerto Rico | $11.45 | $10.29 | 1.1x | 43,702 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.