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 $45.03. Illinois pays $46.04, 2% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| AK — Alaska | $140.36 | +212% | 548,245 | 118 | 37% |
| WV — West Virginia | $94.11 | +109% | 698,760 | 141 | 24% |
| VT — Vermont | $88.89 | +97% | 55,572 | 37 | 24% |
| OK — Oklahoma | $81.14 | +80% | 1,557,619 | 196 | 20% |
| DC — District of Columbia | $72.68 | +61% | 290,405 | 42 | 27% |
| TX — Texas | $72.15 | +60% | 7,473,737 | 1,623 | 27% |
| NC — North Carolina | $69.14 | +54% | 5,434,015 | 524 | 24% |
| NM — New Mexico | $68.41 | +52% | 1,075,523 | 216 | 31% |
| ID — Idaho | $67.55 | +50% | 1,625,609 | 282 | 15% |
| SC — South Carolina | $66.37 | +47% | 2,863,144 | 347 | 19% |
| GA — Georgia | $64.44 | +43% | 477,188 | 87 | 5% |
| OR — Oregon | $63.07 | +40% | 1,138,466 | 284 | 9% |
| ND — North Dakota | $61.11 | +36% | 424,350 | 67 | 27% |
| MN — Minnesota | $60.80 | +35% | 1,747,475 | 265 | 24% |
| AR — Arkansas | $59.02 | +31% | 7,016,561 | 582 | 19% |
| VA — Virginia | $58.31 | +29% | 2,802,516 | 403 | 26% |
| AZ — Arizona | $57.62 | +28% | 4,033,544 | 512 | 27% |
| NY — New York | $56.33 | +25% | 11,795,512 | 2,067 | 29% |
| MT — Montana | $55.71 | +24% | 729,211 | 197 | 44% |
| NV — Nevada | $54.89 | +22% | 2,099,955 | 308 | 22% |
| WY — Wyoming | $52.65 | +17% | 134,346 | 39 | 19% |
| CO — Colorado | $51.36 | +14% | 2,982,349 | 684 | 31% |
| KY — Kentucky | $50.85 | +13% | 2,521,623 | 545 | 23% |
| MD — Maryland | $49.34 | +10% | 2,143,369 | 484 | 21% |
| IL — Illinois | $46.04 | +2% | 815,513 | 350 | 11% |
| WA — Washington | $45.03 | −0% | 3,209,062 | 590 | 14% |
| HI — Hawaii | $44.36 | −1% | 77,660 | 52 | 17% |
| LA — Louisiana | $43.57 | −3% | 1,786,159 | 330 | 20% |
| FL — Florida | $43.04 | −4% | 17,031,473 | 2,325 | 17% |
| PA — Pennsylvania | $42.71 | −5% | 4,023,196 | 714 | 16% |
| IN — Indiana | $41.56 | −8% | 3,716,699 | 412 | 15% |
| NE — Nebraska | $40.85 | −9% | 571,850 | 132 | 9% |
| NJ — New Jersey | $40.64 | −10% | 2,268,082 | 523 | 36% |
| MI — Michigan | $40.64 | −10% | 2,692,772 | 389 | 28% |
| UT — Utah | $38.60 | −14% | 174,702 | 133 | 16% |
| AL — Alabama | $37.86 | −16% | 1,540,953 | 321 | 21% |
| TN — Tennessee | $36.34 | −19% | 3,331,709 | 341 | 26% |
| WI — Wisconsin | $35.36 | −21% | 999,561 | 267 | 15% |
| RI — Rhode Island | $35.29 | −22% | 425,154 | 267 | 35% |
| ME — Maine | $34.88 | −23% | 868,022 | 201 | 38% |
| MO — Missouri | $34.30 | −24% | 1,361,449 | 476 | 35% |
| SD — South Dakota | $34.02 | −24% | 121,214 | 54 | 35% |
| IA — Iowa | $32.32 | −28% | 493,252 | 133 | 23% |
| MA — Massachusetts | $29.33 | −35% | 1,559,286 | 493 | 37% |
| OH — Ohio | $29.20 | −35% | 4,580,208 | 1,064 | 23% |
| KS — Kansas | $26.46 | −41% | 913,534 | 311 | 30% |
| CA — California | $25.74 | −43% | 5,402,783 | 1,192 | 17% |
| CT — Connecticut | $25.18 | −44% | 2,504,714 | 228 | 41% |
| MS — Mississippi | $22.78 | −49% | 3,167,990 | 345 | 21% |
| NH — New Hampshire | $20.65 | −54% | 1,072,112 | 204 | 40% |
| DE — Delaware | $19.61 | −56% | 729,600 | 80 | 22% |
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.