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 $179.77. South Carolina pays $114.40, 36% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| IL — Illinois | $905.95 | +404% | 1,612,255 | 362 | 11% |
| DC — District of Columbia | $649.11 | +261% | 103,558 | 4 | 27% |
| AZ — Arizona | $583.54 | +225% | 930,775 | 102 | 27% |
| MN — Minnesota | $468.92 | +161% | 635,837 | 60 | 24% |
| ND — North Dakota | $366.21 | +104% | 59,105 | 17 | 27% |
| NJ — New Jersey | $308.51 | +72% | 316,653 | 29 | 36% |
| PA — Pennsylvania | $301.36 | +68% | 597,264 | 285 | 16% |
| NV — Nevada | $299.49 | +67% | 572,067 | 30 | 22% |
| NM — New Mexico | $268.00 | +49% | 404,205 | 53 | 31% |
| WV — West Virginia | $259.05 | +44% | 270,646 | 96 | 24% |
| LA — Louisiana | $249.29 | +39% | 1,263,410 | 54 | 20% |
| OK — Oklahoma | $240.47 | +34% | 570,859 | 87 | 20% |
| OR — Oregon | $236.76 | +32% | 746,580 | 88 | 9% |
| MO — Missouri | $231.10 | +29% | 802,328 | 171 | 35% |
| MI — Michigan | $226.56 | +26% | 935,494 | 163 | 28% |
| CA — California | $223.95 | +25% | 4,086,280 | 249 | 17% |
| VT — Vermont | $223.90 | +25% | 56,965 | 48 | 24% |
| ID — Idaho | $219.85 | +22% | 93,547 | 31 | 15% |
| HI — Hawaii | $209.97 | +17% | 143,575 | 4 | 17% |
| NY — New York | $196.01 | +9% | 1,704,175 | 313 | 29% |
| ME — Maine | $195.86 | +9% | 191,139 | 103 | 38% |
| CT — Connecticut | $191.07 | +6% | 1,048,520 | 80 | 41% |
| NE — Nebraska | $184.55 | +3% | 117,118 | 25 | 9% |
| MA — Massachusetts | $182.89 | +2% | 882,756 | 218 | 37% |
| IN — Indiana | $180.69 | +1% | 745,947 | 182 | 15% |
| MT — Montana | $179.77 | −0% | 43,676 | 29 | 44% |
| TX — Texas | $179.03 | −0% | 1,309,055 | 319 | 27% |
| SD — South Dakota | $178.94 | −0% | 56,665 | 36 | 35% |
| MS — Mississippi | $161.60 | −10% | 568,075 | 49 | 21% |
| AR — Arkansas | $153.51 | −15% | 494,147 | 80 | 19% |
| WI — Wisconsin | $148.76 | −17% | 415,570 | 166 | 15% |
| CO — Colorado | $138.62 | −23% | 863,627 | 125 | 31% |
| NC — North Carolina | $136.49 | −24% | 1,507,577 | 168 | 24% |
| GA — Georgia | $130.78 | −27% | 27,902 | 21 | 5% |
| OH — Ohio | $121.51 | −32% | 1,518,693 | 505 | 23% |
| KS — Kansas | $118.49 | −34% | 176,578 | 62 | 30% |
| TN — Tennessee | $117.92 | −34% | 1,433,923 | 120 | 26% |
| WA — Washington | $117.25 | −35% | 346,650 | 99 | 14% |
| SC — South Carolina | $114.40 | −36% | 413,681 | 90 | 19% |
| FL — Florida | $112.03 | −38% | 2,145,975 | 163 | 17% |
| NH — New Hampshire | $108.74 | −40% | 67,668 | 50 | 40% |
| UT — Utah | $102.38 | −43% | 34,456 | 26 | 16% |
| VA — Virginia | $91.68 | −49% | 707,520 | 199 | 26% |
| WY — Wyoming | $90.11 | −50% | 27,189 | 13 | 19% |
| MD — Maryland | $88.06 | −51% | 988,687 | 87 | 21% |
| AL — Alabama | $87.32 | −51% | 443,372 | 102 | 21% |
| RI — Rhode Island | $85.00 | −53% | 125,289 | 39 | 35% |
| IA — Iowa | $78.02 | −57% | 212,466 | 92 | 23% |
| AK — Alaska | $71.44 | −60% | 79,039 | 16 | 37% |
| DE — Delaware | $68.05 | −62% | 2,437 | 3 | 22% |
| KY — Kentucky | $64.41 | −64% | 879,388 | 176 | 23% |
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.