Code 99285. Medicare covered 9,078,142 of these. Here is what providers billed and what Medicare allowed, state by state.
Providers in Louisiana billed the most for this, at $1,928.15. In Vermont the average was $661.99. 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 |
|---|---|---|---|---|
| Louisiana | $1,928.15 | $165.75 | 11.6x | 145,057 |
| Armed Forces Europe | $1,789.79 | $165.84 | 10.8x | 946 |
| Armed Forces Central/South America | $1,629.81 | $180.94 | 9.0x | 405 |
| Foreign Country | $1,627.15 | $168.03 | 9.7x | 969 |
| Nevada | $1,542.66 | $165.92 | 9.3x | 76,194 |
| Georgia | $1,541.48 | $167.56 | 9.2x | 237,135 |
| Mississippi | $1,537.97 | $163.25 | 9.4x | 103,590 |
| Northern Mariana Islands | $1,528.52 | $146.74 | 10.4x | 27 |
| Texas | $1,525.29 | $168.25 | 9.1x | 575,433 |
| Florida | $1,524.27 | $174.66 | 8.7x | 672,634 |
| Tennessee | $1,455.54 | $159.37 | 9.1x | 198,148 |
| Puerto Rico | $1,420.83 | $176.24 | 8.1x | 8,642 |
| Arizona | $1,400.59 | $165.15 | 8.5x | 174,039 |
| Alaska | $1,393.51 | $224.52 | 6.2x | 22,438 |
| New Jersey | $1,342.13 | $178.90 | 7.5x | 280,929 |
| South Carolina | $1,336.25 | $163.58 | 8.2x | 181,713 |
| Oklahoma | $1,324.41 | $161.94 | 8.2x | 134,117 |
| New Mexico | $1,322.21 | $166.98 | 7.9x | 45,592 |
| Guam | $1,322.04 | $172.73 | 7.7x | 1,558 |
| Arkansas | $1,319.78 | $158.62 | 8.3x | 95,327 |
| Alabama | $1,318.54 | $158.34 | 8.3x | 110,200 |
| Ohio | $1,291.06 | $166.39 | 7.8x | 397,989 |
| Maryland | $1,242.13 | $173.84 | 7.1x | 188,092 |
| Michigan | $1,221.64 | $172.50 | 7.1x | 374,366 |
| Armed Forces Pacific | $1,217.62 | $175.95 | 6.9x | 1,334 |
| Kentucky | $1,210.13 | $163.51 | 7.4x | 146,401 |
| Hawaii | $1,196.87 | $166.08 | 7.2x | 25,440 |
| Washington | $1,193.10 | $170.77 | 7.0x | 135,271 |
| Wisconsin | $1,177.14 | $158.94 | 7.4x | 132,011 |
| Wyoming | $1,172.81 | $161.99 | 7.2x | 13,225 |
| West Virginia | $1,153.79 | $166.75 | 6.9x | 46,441 |
| California | $1,149.33 | $175.08 | 6.6x | 857,773 |
| Virginia | $1,148.98 | $166.35 | 6.9x | 255,156 |
| Connecticut | $1,146.69 | $174.86 | 6.6x | 102,284 |
| New York | $1,142.59 | $181.48 | 6.3x | 567,743 |
| Colorado | $1,133.43 | $168.79 | 6.7x | 114,387 |
| North Carolina | $1,126.20 | $160.68 | 7.0x | 297,661 |
| Illinois | $1,125.34 | $175.82 | 6.4x | 438,131 |
| Indiana | $1,123.42 | $160.76 | 7.0x | 200,458 |
| Delaware | $1,120.57 | $169.32 | 6.6x | 46,063 |
| Kansas | $1,109.77 | $158.04 | 7.0x | 82,855 |
| Missouri | $1,106.08 | $165.26 | 6.7x | 170,178 |
| Utah | $1,105.77 | $167.03 | 6.6x | 48,880 |
| Rhode Island | $1,090.82 | $171.12 | 6.4x | 46,264 |
| Idaho | $1,087.16 | $157.95 | 6.9x | 29,404 |
| Virgin Islands | $1,031.71 | $155.00 | 6.7x | 325 |
| Maine | $988.28 | $167.03 | 5.9x | 36,072 |
| Oregon | $972.70 | $167.08 | 5.8x | 77,593 |
| Iowa | $968.05 | $155.71 | 6.2x | 71,612 |
| District of Columbia | $957.05 | $180.64 | 5.3x | 29,592 |
| Pennsylvania | $944.68 | $169.36 | 5.6x | 500,257 |
| Minnesota | $938.24 | $161.39 | 5.8x | 130,367 |
| New Hampshire | $905.87 | $164.51 | 5.5x | 44,715 |
| Nebraska | $874.85 | $155.17 | 5.6x | 32,569 |
| South Dakota | $828.99 | $159.02 | 5.2x | 21,685 |
| Massachusetts | $763.88 | $172.14 | 4.4x | 283,882 |
| North Dakota | $723.50 | $163.51 | 4.4x | 20,548 |
| Montana | $683.51 | $169.61 | 4.0x | 28,606 |
| Vermont | $661.99 | $162.54 | 4.1x | 17,332 |
Source: CMS Medicare Physician & Other Practitioners, by Geography and Service. Weighted by service volume across places of service.