Code 99212. Medicare covered 6,770,558 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Alaska billed the most for this, at $155.66. In Northern Mariana Islands the average was $53.98. 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 |
|---|---|---|---|---|
| Alaska | $155.66 | $58.87 | 2.6x | 18,100 |
| Massachusetts | $153.57 | $53.16 | 2.9x | 171,016 |
| Wisconsin | $145.44 | $44.41 | 3.3x | 100,214 |
| Minnesota | $144.46 | $48.87 | 3.0x | 76,194 |
| New York | $143.89 | $58.30 | 2.5x | 644,341 |
| Oregon | $138.41 | $49.02 | 2.8x | 68,033 |
| California | $135.72 | $58.32 | 2.3x | 705,800 |
| New Jersey | $129.70 | $58.18 | 2.2x | 294,778 |
| Washington | $125.05 | $51.53 | 2.4x | 99,115 |
| Rhode Island | $123.90 | $52.48 | 2.4x | 23,584 |
| Nebraska | $122.73 | $47.10 | 2.6x | 48,564 |
| Georgia | $122.24 | $49.50 | 2.5x | 166,629 |
| Nevada | $121.24 | $50.91 | 2.4x | 60,591 |
| Colorado | $121.07 | $52.83 | 2.3x | 92,580 |
| Armed Forces Europe | $119.60 | $54.56 | 2.2x | 77 |
| Foreign Country | $118.99 | $48.04 | 2.5x | 71 |
| New Hampshire | $118.42 | $47.13 | 2.5x | 35,887 |
| Connecticut | $118.02 | $55.02 | 2.1x | 72,861 |
| Wyoming | $116.42 | $51.45 | 2.3x | 21,136 |
| Illinois | $114.90 | $51.70 | 2.2x | 265,746 |
| Arizona | $114.71 | $50.59 | 2.3x | 166,785 |
| Maryland | $114.02 | $55.44 | 2.1x | 163,586 |
| Florida | $113.85 | $52.96 | 2.1x | 525,126 |
| District of Columbia | $113.67 | $57.99 | 2.0x | 16,755 |
| Texas | $112.08 | $50.76 | 2.2x | 370,272 |
| Guam | $110.68 | $47.80 | 2.3x | 798 |
| Armed Forces Pacific | $110.27 | $53.13 | 2.1x | 96 |
| New Mexico | $107.88 | $46.72 | 2.3x | 39,123 |
| Ohio | $107.39 | $46.91 | 2.3x | 228,735 |
| North Carolina | $107.32 | $48.66 | 2.2x | 178,831 |
| Hawaii | $106.81 | $53.97 | 2.0x | 25,162 |
| Utah | $106.26 | $49.33 | 2.2x | 38,340 |
| Iowa | $106.25 | $47.30 | 2.2x | 77,051 |
| Virginia | $104.78 | $51.27 | 2.0x | 192,143 |
| Montana | $104.47 | $47.87 | 2.2x | 31,110 |
| Delaware | $104.39 | $51.79 | 2.0x | 37,808 |
| Pennsylvania | $103.88 | $50.98 | 2.0x | 311,783 |
| Missouri | $103.44 | $46.76 | 2.2x | 121,500 |
| West Virginia | $103.39 | $43.03 | 2.4x | 44,569 |
| North Dakota | $103.11 | $41.75 | 2.5x | 19,563 |
| Maine | $102.09 | $45.94 | 2.2x | 22,718 |
| South Dakota | $101.29 | $45.32 | 2.2x | 23,584 |
| Louisiana | $100.93 | $48.52 | 2.1x | 82,913 |
| Idaho | $100.70 | $44.14 | 2.3x | 33,278 |
| Oklahoma | $100.07 | $46.90 | 2.1x | 77,690 |
| Tennessee | $100.03 | $47.41 | 2.1x | 134,275 |
| Michigan | $98.25 | $50.29 | 2.0x | 158,157 |
| Kansas | $98.22 | $47.38 | 2.1x | 69,558 |
| South Carolina | $97.80 | $49.13 | 2.0x | 135,051 |
| Unknown | $95.48 | $49.51 | 1.9x | 54 |
| Indiana | $95.11 | $48.36 | 2.0x | 140,336 |
| Kentucky | $94.88 | $47.37 | 2.0x | 89,518 |
| Virgin Islands | $93.35 | $53.28 | 1.8x | 1,182 |
| Alabama | $89.57 | $47.13 | 1.9x | 78,416 |
| Arkansas | $85.39 | $45.74 | 1.9x | 70,851 |
| Mississippi | $83.52 | $45.54 | 1.8x | 72,257 |
| Vermont | $76.28 | $42.62 | 1.8x | 14,316 |
| Puerto Rico | $58.79 | $51.06 | 1.2x | 11,502 |
| Northern Mariana Islands | $53.98 | $39.81 | 1.4x | 435 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.