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 $153.63. Wisconsin pays $145.30, 5% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| IL — Illinois | $769.27 | +401% | 1,252,707 | 339 | 11% |
| UT — Utah | $715.87 | +366% | 279,077 | 56 | 16% |
| DC — District of Columbia | $579.24 | +277% | 235,198 | 3 | 27% |
| AZ — Arizona | $569.61 | +271% | 670,181 | 82 | 27% |
| MN — Minnesota | $425.75 | +177% | 424,777 | 78 | 24% |
| ND — North Dakota | $342.00 | +123% | 69,288 | 15 | 27% |
| NM — New Mexico | $263.52 | +72% | 250,634 | 56 | 31% |
| PA — Pennsylvania | $249.93 | +63% | 859,334 | 385 | 16% |
| WV — West Virginia | $216.74 | +41% | 366,858 | 113 | 24% |
| CA — California | $215.29 | +40% | 2,738,452 | 387 | 17% |
| NV — Nevada | $211.79 | +38% | 289,262 | 27 | 22% |
| OK — Oklahoma | $210.03 | +37% | 213,714 | 81 | 20% |
| MO — Missouri | $200.50 | +31% | 541,124 | 135 | 35% |
| VT — Vermont | $192.88 | +26% | 76,766 | 40 | 24% |
| HI — Hawaii | $184.76 | +20% | 57,359 | 4 | 17% |
| ID — Idaho | $182.61 | +19% | 75,101 | 32 | 15% |
| MA — Massachusetts | $182.12 | +19% | 1,611,829 | 242 | 37% |
| CT — Connecticut | $179.37 | +17% | 1,833,716 | 122 | 41% |
| ME — Maine | $177.55 | +16% | 171,009 | 96 | 38% |
| NY — New York | $166.82 | +9% | 3,963,650 | 423 | 29% |
| OR — Oregon | $166.16 | +8% | 270,862 | 68 | 9% |
| MS — Mississippi | $162.35 | +6% | 329,636 | 39 | 21% |
| MT — Montana | $161.51 | +5% | 94,964 | 41 | 44% |
| TX — Texas | $159.88 | +4% | 927,386 | 312 | 27% |
| IN — Indiana | $158.29 | +3% | 899,915 | 196 | 15% |
| SD — South Dakota | $153.63 | −0% | 43,225 | 34 | 35% |
| MI — Michigan | $152.82 | −1% | 952,463 | 153 | 28% |
| WI — Wisconsin | $145.30 | −5% | 506,041 | 153 | 15% |
| LA — Louisiana | $140.70 | −8% | 556,505 | 43 | 20% |
| GA — Georgia | $139.00 | −10% | 113,887 | 16 | 5% |
| AR — Arkansas | $127.06 | −17% | 226,948 | 62 | 19% |
| CO — Colorado | $123.41 | −20% | 792,534 | 116 | 31% |
| WA — Washington | $116.15 | −24% | 927,633 | 146 | 14% |
| KS — Kansas | $115.57 | −25% | 103,754 | 51 | 30% |
| NC — North Carolina | $112.43 | −27% | 879,690 | 144 | 24% |
| NJ — New Jersey | $112.21 | −27% | 1,606,998 | 264 | 36% |
| NE — Nebraska | $111.16 | −28% | 110,672 | 29 | 9% |
| TN — Tennessee | $108.52 | −29% | 647,348 | 108 | 26% |
| NH — New Hampshire | $100.25 | −35% | 53,496 | 45 | 40% |
| SC — South Carolina | $92.00 | −40% | 533,364 | 85 | 19% |
| FL — Florida | $90.98 | −41% | 1,095,710 | 143 | 17% |
| WY — Wyoming | $89.25 | −42% | 19,113 | 13 | 19% |
| OH — Ohio | $86.28 | −44% | 1,431,139 | 475 | 23% |
| AK — Alaska | $81.29 | −47% | 104,903 | 22 | 37% |
| VA — Virginia | $80.18 | −48% | 846,305 | 221 | 26% |
| RI — Rhode Island | $78.10 | −49% | 162,528 | 35 | 35% |
| AL — Alabama | $74.53 | −51% | 261,762 | 93 | 21% |
| IA — Iowa | $70.93 | −54% | 177,963 | 94 | 23% |
| DE — Delaware | $53.31 | −65% | 241,919 | 61 | 22% |
| KY — Kentucky | $52.10 | −66% | 603,465 | 169 | 23% |
| MD — Maryland | $3.33 | −98% | 177,507 | 44 | 21% |
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.