93306

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

Code 93306. Medicare covered 6,792,070 of these. Here is what providers billed and what Medicare allowed, state by state.

$475.05Billed, national avg
$113.00Medicare allowed
4.2xBilled vs allowed
10.0xHighest vs lowest state

Providers in Wyoming billed the most for this, at $1,384.84. In Guam the average was $138.35. 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
Wyoming$1,384.84$136.0010.2x8,628
Alaska$1,288.64$139.189.3x12,843
Wisconsin$1,063.11$84.8112.5x86,177
New York$730.19$146.005.0x536,464
South Carolina$725.87$102.927.1x136,655
Mississippi$612.41$104.705.8x71,901
Connecticut$582.01$109.915.3x68,338
Delaware$574.19$132.054.3x32,984
District of Columbia$570.38$143.554.0x20,936
Louisiana$566.54$117.324.8x96,316
Maryland$525.33$148.523.5x172,847
California$524.10$146.913.6x777,002
New Jersey$518.06$133.033.9x257,050
New Hampshire$514.96$70.107.3x36,481
Texas$510.37$120.354.2x483,218
Hawaii$506.92$119.514.2x15,472
Kansas$504.57$92.535.5x76,841
Georgia$481.70$103.334.7x185,030
Illinois$471.28$97.654.8x275,465
Minnesota$468.35$82.915.6x80,782
North Carolina$462.79$99.474.7x194,322
Pennsylvania$444.91$99.194.5x297,617
Nevada$435.03$120.593.6x61,320
Arizona$433.35$138.503.1x167,061
Oregon$431.60$86.485.0x56,324
Massachusetts$417.95$105.154.0x184,240
Missouri$402.54$76.155.3x119,425
Florida$395.15$125.863.1x585,036
Rhode Island$390.30$108.383.6x17,642
Vermont$385.83$70.515.5x10,526
Iowa$378.73$83.674.5x55,597
Arkansas$360.78$79.894.5x84,660
Tennessee$347.48$86.914.0x144,473
Virginia$345.92$105.713.3x184,891
West Virginia$343.23$81.844.2x27,403
Alabama$340.63$105.493.2x101,627
Michigan$330.36$94.033.5x164,567
Nebraska$327.25$85.893.8x42,180
Unknown$320.00$189.981.7x167
Washington$318.53$93.333.4x112,078
Colorado$318.12$90.383.5x69,328
Ohio$309.64$76.814.0x193,401
Maine$306.33$71.654.3x21,062
Virgin Islands$305.81$166.911.8x903
Oklahoma$297.66$81.063.7x91,531
Indiana$291.84$73.184.0x128,650
North Dakota$287.80$71.094.0x21,593
South Dakota$280.00$68.204.1x27,324
Kentucky$273.76$81.033.4x83,282
Montana$273.26$82.833.3x20,398
New Mexico$271.16$82.523.3x26,779
Utah$269.00$90.543.0x33,261
Idaho$260.45$74.013.5x22,466
Puerto Rico$218.09$150.101.5x7,111
Armed Forces Europe$189.54$67.502.8x13
Guam$138.35$107.671.3x2,381

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

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