What each state pays for the same procedure. Start from a code — no need to pick a state first.
Restricted to widely-billed codes: a procedure billed in four states cannot tell you whether your rate is unusual.
Average paid per claim across 51 reporting states. National median $58.42. West Virginia pays $40.13, 31% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| AK — Alaska | $180.76 | +209% | 175,772 | 89 | 37% |
| SC — South Carolina | $134.00 | +129% | 1,104,207 | 208 | 19% |
| NY — New York | $124.93 | +114% | 15,758,834 | 2,208 | 29% |
| UT — Utah | $116.18 | +99% | 419,788 | 111 | 16% |
| MD — Maryland | $110.75 | +90% | 11,869,974 | 2,211 | 21% |
| HI — Hawaii | $100.59 | +72% | 96,437 | 81 | 17% |
| NE — Nebraska | $99.60 | +70% | 868,305 | 518 | 9% |
| OR — Oregon | $88.12 | +51% | 696,642 | 404 | 9% |
| NJ — New Jersey | $83.83 | +43% | 5,421,676 | 723 | 36% |
| MN — Minnesota | $83.62 | +43% | 2,696,504 | 626 | 24% |
| PA — Pennsylvania | $81.83 | +40% | 8,579,941 | 692 | 16% |
| MI — Michigan | $81.26 | +39% | 3,836,696 | 950 | 28% |
| CA — California | $79.81 | +37% | 4,363,036 | 1,959 | 17% |
| NM — New Mexico | $79.33 | +36% | 1,023,600 | 382 | 31% |
| MA — Massachusetts | $76.43 | +31% | 12,689,881 | 1,628 | 37% |
| ND — North Dakota | $75.83 | +30% | 148,054 | 85 | 27% |
| CO — Colorado | $74.99 | +28% | 944,839 | 594 | 31% |
| IA — Iowa | $73.56 | +26% | 3,156,413 | 681 | 23% |
| RI — Rhode Island | $68.88 | +18% | 1,028,587 | 758 | 35% |
| MS — Mississippi | $68.14 | +17% | 531,388 | 162 | 21% |
| GA — Georgia | $65.56 | +12% | 310,844 | 294 | 5% |
| AL — Alabama | $64.61 | +11% | 285,446 | 105 | 21% |
| VA — Virginia | $62.62 | +7% | 1,172,395 | 667 | 26% |
| SD — South Dakota | $59.71 | +2% | 74,048 | 83 | 35% |
| AR — Arkansas | $58.71 | +0% | 384,867 | 233 | 19% |
| IN — Indiana | $58.42 | −0% | 5,826,549 | 587 | 15% |
| KY — Kentucky | $58.39 | −0% | 1,318,848 | 505 | 23% |
| ID — Idaho | $57.37 | −2% | 1,279,737 | 420 | 15% |
| DC — District of Columbia | $56.64 | −3% | 207,742 | 101 | 27% |
| OH — Ohio | $54.61 | −7% | 3,585,530 | 1,332 | 23% |
| TN — Tennessee | $53.85 | −8% | 2,771,999 | 365 | 26% |
| KS — Kansas | $53.83 | −8% | 452,296 | 279 | 30% |
| NV — Nevada | $51.29 | −12% | 429,926 | 339 | 22% |
| WA — Washington | $50.78 | −13% | 1,172,995 | 394 | 14% |
| NH — New Hampshire | $49.16 | −16% | 916,592 | 133 | 40% |
| NC — North Carolina | $47.98 | −18% | 817,329 | 626 | 24% |
| CT — Connecticut | $45.30 | −22% | 4,973,772 | 574 | 41% |
| WY — Wyoming | $44.25 | −24% | 27,608 | 36 | 19% |
| AZ — Arizona | $40.94 | −30% | 199,656 | 178 | 27% |
| DE — Delaware | $40.83 | −30% | 371,258 | 85 | 22% |
| WV — West Virginia | $40.13 | −31% | 320,163 | 216 | 24% |
| TX — Texas | $39.92 | −32% | 1,787,460 | 825 | 27% |
| WI — Wisconsin | $37.82 | −35% | 2,293,618 | 790 | 15% |
| FL — Florida | $36.12 | −38% | 233,523 | 286 | 17% |
| MO — Missouri | $35.49 | −39% | 1,746,249 | 1,068 | 35% |
| MT — Montana | $29.54 | −49% | 298,964 | 232 | 44% |
| IL — Illinois | $28.61 | −51% | 648,827 | 721 | 11% |
| OK — Oklahoma | $27.26 | −53% | 103,626 | 57 | 20% |
| VT — Vermont | $20.45 | −65% | 289,728 | 166 | 24% |
| LA — Louisiana | $19.02 | −67% | 628,645 | 463 | 20% |
| ME — Maine | $19.02 | −67% | 326,894 | 133 | 38% |
Average paid per claim is a ratio internal to the claims data, so unlike per-enrollee measures it needs no external denominator. It remains subject to one caveat: this extract carries no claim-type field, so fee-for-service claims and managed-care encounter records are mixed together, and states derive encounter amounts inconsistently. The coverage column indicates how much of each state’s program these claims represent.