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 $46.40. Montana pays $44.48, 4% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| AK — Alaska | $262.13 | +465% | 1,934,000 | 487 | 37% |
| SD — South Dakota | $104.29 | +125% | 1,685,681 | 345 | 35% |
| ND — North Dakota | $96.93 | +109% | 1,078,275 | 209 | 27% |
| CO — Colorado | $95.61 | +106% | 9,374,544 | 2,602 | 31% |
| HI — Hawaii | $88.45 | +91% | 2,191,443 | 718 | 17% |
| NM — New Mexico | $83.74 | +80% | 5,815,171 | 943 | 31% |
| KS — Kansas | $83.46 | +80% | 3,349,873 | 1,065 | 30% |
| MD — Maryland | $77.26 | +67% | 12,537,758 | 3,310 | 21% |
| UT — Utah | $74.30 | +60% | 2,281,220 | 1,359 | 16% |
| NY — New York | $72.59 | +56% | 83,900,820 | 19,231 | 29% |
| MN — Minnesota | $68.23 | +47% | 9,686,023 | 1,213 | 24% |
| OK — Oklahoma | $66.69 | +44% | 6,765,769 | 1,801 | 20% |
| NE — Nebraska | $66.16 | +43% | 3,220,361 | 707 | 9% |
| GA — Georgia | $64.96 | +40% | 5,094,475 | 923 | 5% |
| SC — South Carolina | $64.90 | +40% | 10,855,695 | 2,782 | 19% |
| MO — Missouri | $56.70 | +22% | 8,463,803 | 4,374 | 35% |
| MA — Massachusetts | $56.23 | +21% | 15,565,162 | 5,352 | 37% |
| MS — Mississippi | $56.11 | +21% | 9,494,796 | 1,933 | 21% |
| VA — Virginia | $54.72 | +18% | 14,662,600 | 4,042 | 26% |
| RI — Rhode Island | $52.65 | +13% | 2,819,034 | 2,053 | 35% |
| OR — Oregon | $51.17 | +10% | 7,365,100 | 1,615 | 9% |
| DC — District of Columbia | $49.70 | +7% | 1,993,671 | 325 | 27% |
| IN — Indiana | $47.65 | +3% | 18,833,259 | 2,395 | 15% |
| MI — Michigan | $47.52 | +2% | 24,849,476 | 4,776 | 28% |
| NC — North Carolina | $46.93 | +1% | 19,545,668 | 4,202 | 24% |
| NV — Nevada | $46.40 | −0% | 5,796,056 | 2,513 | 22% |
| AZ — Arizona | $46.07 | −1% | 16,106,787 | 2,811 | 27% |
| NJ — New Jersey | $45.39 | −2% | 23,768,501 | 4,478 | 36% |
| MT — Montana | $44.48 | −4% | 2,315,587 | 536 | 44% |
| WA — Washington | $43.51 | −6% | 12,698,103 | 1,895 | 14% |
| OH — Ohio | $43.03 | −7% | 38,412,388 | 5,173 | 23% |
| FL — Florida | $41.78 | −10% | 24,326,233 | 6,084 | 17% |
| AL — Alabama | $41.52 | −11% | 8,891,603 | 1,997 | 21% |
| ID — Idaho | $40.98 | −12% | 3,162,905 | 679 | 15% |
| TX — Texas | $38.90 | −16% | 36,238,045 | 6,084 | 27% |
| DE — Delaware | $38.60 | −17% | 2,599,394 | 545 | 22% |
| PA — Pennsylvania | $37.62 | −19% | 13,276,992 | 8,968 | 16% |
| WI — Wisconsin | $36.81 | −21% | 8,269,744 | 1,780 | 15% |
| TN — Tennessee | $34.97 | −25% | 21,356,472 | 4,084 | 26% |
| WV — West Virginia | $34.30 | −26% | 9,164,023 | 1,286 | 24% |
| WY — Wyoming | $33.73 | −27% | 511,865 | 259 | 19% |
| CT — Connecticut | $32.71 | −30% | 25,510,528 | 1,731 | 41% |
| KY — Kentucky | $32.13 | −31% | 30,914,140 | 3,396 | 23% |
| NH — New Hampshire | $31.91 | −31% | 1,743,335 | 405 | 40% |
| AR — Arkansas | $28.46 | −39% | 5,442,466 | 1,766 | 19% |
| LA — Louisiana | $25.46 | −45% | 26,094,490 | 3,265 | 20% |
| IA — Iowa | $24.21 | −48% | 8,391,788 | 1,333 | 23% |
| IL — Illinois | $23.30 | −50% | 23,870,295 | 14,315 | 11% |
| ME — Maine | $19.99 | −57% | 3,133,951 | 491 | 38% |
| VT — Vermont | $19.00 | −59% | 1,487,984 | 323 | 24% |
| CA — California | $14.42 | −69% | 124,469,957 | 14,704 | 17% |
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.