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 49 reporting states. National median $162.35. Pennsylvania pays $222.06, 37% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| IN — Indiana | $434.50 | +168% | 1,692,418 | 96 | 15% |
| NE — Nebraska | $402.15 | +148% | 4,384 | 7 | 9% |
| NC — North Carolina | $313.62 | +93% | 1,782,657 | 88 | 24% |
| CO — Colorado | $262.32 | +62% | 887,915 | 156 | 31% |
| UT — Utah | $258.19 | +59% | 978,921 | 29 | 16% |
| GA — Georgia | $234.79 | +45% | 65,012 | 9 | 5% |
| OH — Ohio | $230.89 | +42% | 317,353 | 43 | 23% |
| NH — New Hampshire | $224.16 | +38% | 51,086 | 20 | 40% |
| MA — Massachusetts | $224.01 | +38% | 579,131 | 154 | 37% |
| PA — Pennsylvania | $222.06 | +37% | 2,668,072 | 145 | 16% |
| VA — Virginia | $210.01 | +29% | 682,385 | 91 | 26% |
| OR — Oregon | $202.58 | +25% | 34,350 | 13 | 9% |
| KS — Kansas | $194.77 | +20% | 16,619 | 9 | 30% |
| NM — New Mexico | $190.93 | +18% | 22,261 | 11 | 31% |
| AR — Arkansas | $190.56 | +17% | 139,963 | 23 | 19% |
| NJ — New Jersey | $190.05 | +17% | 369,167 | 67 | 36% |
| MI — Michigan | $187.23 | +15% | 5,318,319 | 131 | 28% |
| AZ — Arizona | $186.54 | +15% | 321,021 | 52 | 27% |
| MD — Maryland | $185.50 | +14% | 164,048 | 25 | 21% |
| HI — Hawaii | $185.37 | +14% | 8,488 | 7 | 17% |
| ID — Idaho | $182.62 | +12% | 23,690 | 4 | 15% |
| CT — Connecticut | $174.88 | +8% | 517,250 | 52 | 41% |
| AK — Alaska | $174.30 | +7% | 20,683 | 12 | 37% |
| TN — Tennessee | $165.53 | +2% | 211,345 | 62 | 26% |
| RI — Rhode Island | $162.35 | −0% | 5,617 | 3 | 35% |
| MO — Missouri | $161.22 | −1% | 203,955 | 56 | 35% |
| NV — Nevada | $154.78 | −5% | 26,749 | 28 | 22% |
| KY — Kentucky | $154.00 | −5% | 136,439 | 37 | 23% |
| NY — New York | $151.63 | −7% | 739,739 | 72 | 29% |
| CA — California | $151.15 | −7% | 1,535,838 | 90 | 17% |
| FL — Florida | $148.35 | −9% | 722,789 | 178 | 17% |
| SC — South Carolina | $145.19 | −11% | 117,115 | 24 | 19% |
| IL — Illinois | $140.00 | −14% | 105,552 | 14 | 11% |
| WV — West Virginia | $136.72 | −16% | 24,586 | 6 | 24% |
| TX — Texas | $136.29 | −16% | 382,002 | 43 | 27% |
| IA — Iowa | $134.70 | −17% | 221,886 | 13 | 23% |
| AL — Alabama | $131.04 | −19% | 136,095 | 28 | 21% |
| DE — Delaware | $127.03 | −22% | 34,122 | 3 | 22% |
| WA — Washington | $124.61 | −23% | 284,344 | 36 | 14% |
| OK — Oklahoma | $121.32 | −25% | 104,497 | 15 | 20% |
| LA — Louisiana | $106.91 | −34% | 834,951 | 64 | 20% |
| MT — Montana | $102.42 | −37% | 15,420 | 7 | 44% |
| SD — South Dakota | $90.49 | −44% | 51,445 | 5 | 35% |
| MN — Minnesota | $87.73 | −46% | 1,586,853 | 45 | 24% |
| MS — Mississippi | $85.88 | −47% | 35,442 | 11 | 21% |
| WI — Wisconsin | $83.37 | −49% | 1,982,867 | 114 | 15% |
| ND — North Dakota | $19.21 | −88% | 1,835 | 3 | 27% |
| VT — Vermont | $6.56 | −96% | 14,691 | 4 | 24% |
| DC — District of Columbia | $0.00 | −100% | 24,727 | 3 | 27% |
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.