83036

Hemoglobin a1c level

Code 83036. Medicare covered 14,591,380 of these. Here is what providers billed and what Medicare allowed, state by state.

$58.04Billed, national avg
$9.49Medicare allowed
6.1xBilled vs allowed
7.8xHighest vs lowest state

Providers in Alaska billed the most for this, at $84.43. In Puerto Rico the average was $10.77. 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
Alaska$84.43$9.409.0x15,705
New Jersey$72.50$9.517.6x1,602,403
Wisconsin$72.30$9.427.7x163,755
Kansas$67.52$9.507.1x283,978
Florida$65.39$9.516.9x1,383,818
Arizona$63.88$9.506.7x476,004
New York$63.49$9.506.7x644,937
Illinois$63.23$9.496.7x382,877
California$63.00$9.496.6x1,595,272
Nevada$62.44$9.506.6x112,161
Texas$62.15$9.506.5x1,269,241
North Carolina$61.19$9.506.4x1,091,059
Georgia$61.07$9.466.5x406,168
Pennsylvania$59.92$9.506.3x233,475
Massachusetts$59.72$9.516.3x341,037
West Virginia$57.72$9.456.1x20,876
Missouri$53.15$9.485.6x120,708
Washington$52.93$9.485.6x233,928
Maryland$52.65$9.495.5x291,116
Mississippi$52.32$9.465.5x200,379
Colorado$51.76$9.485.5x127,720
Guam$50.98$9.415.4x1,089
South Carolina$50.60$9.445.4x221,752
Kentucky$49.73$9.445.3x120,926
Alabama$49.41$9.475.2x379,872
Hawaii$45.90$9.484.8x96,827
Ohio$45.69$9.494.8x559,452
Minnesota$43.89$9.464.6x123,159
Louisiana$43.55$9.484.6x105,910
South Dakota$42.61$9.484.5x25,129
North Dakota$42.26$9.494.5x24,266
Vermont$42.21$9.494.4x14,443
Tennessee$41.11$9.454.3x409,466
Nebraska$41.05$9.464.3x70,879
Wyoming$40.57$9.494.3x12,443
Iowa$40.12$9.464.2x88,380
Unknown$40.00$9.034.4x39
Oregon$39.93$9.454.2x118,211
Indiana$39.10$9.464.1x175,191
District of Columbia$37.42$9.493.9x4,581
Oklahoma$36.68$9.483.9x173,306
New Mexico$36.00$9.393.8x41,302
Connecticut$35.80$9.493.8x44,995
Rhode Island$35.71$9.493.8x25,730
Armed Forces Europe$35.41$9.283.8x69
New Hampshire$35.04$9.483.7x23,041
Montana$34.26$9.433.6x16,724
Arkansas$34.15$9.443.6x90,892
Foreign Country$32.90$9.153.6x26
Maine$32.50$9.483.4x16,583
Armed Forces Pacific$32.24$9.523.4x74
Virginia$31.82$9.483.4x315,722
Idaho$31.66$9.453.4x22,936
Michigan$30.00$9.433.2x155,692
Utah$24.59$9.462.6x75,072
Delaware$22.16$9.452.3x11,314
Virgin Islands$11.48$9.511.2x3,889
Puerto Rico$10.77$9.461.1x25,355

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

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