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 43 reporting states. National median $97.11. Nebraska pays $100.81, 4% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| NY — New York | $496.06 | +411% | 1,837,882 | 54 | 29% |
| CA — California | $248.21 | +156% | 33,658,595 | 584 | 17% |
| AK — Alaska | $227.61 | +134% | 509,212 | 65 | 37% |
| IN — Indiana | $220.27 | +127% | 14,067 | 10 | 15% |
| OH — Ohio | $157.97 | +63% | 54,581 | 17 | 23% |
| CO — Colorado | $156.50 | +61% | 47,930 | 19 | 31% |
| IA — Iowa | $156.04 | +61% | 1,134,325 | 95 | 23% |
| NM — New Mexico | $150.40 | +55% | 975,882 | 124 | 31% |
| MA — Massachusetts | $143.92 | +48% | 4,860,282 | 148 | 37% |
| NJ — New Jersey | $140.34 | +45% | 900,352 | 113 | 36% |
| PA — Pennsylvania | $138.15 | +42% | 85,906 | 15 | 16% |
| NC — North Carolina | $125.91 | +30% | 4,740,632 | 252 | 24% |
| DE — Delaware | $118.93 | +22% | 7,157 | 1 | 22% |
| SC — South Carolina | $116.01 | +19% | 2,932 | 3 | 19% |
| MN — Minnesota | $111.86 | +15% | 870,071 | 140 | 24% |
| CT — Connecticut | $108.86 | +12% | 55,636 | 15 | 41% |
| RI — Rhode Island | $106.16 | +9% | 23,573 | 3 | 35% |
| TN — Tennessee | $105.80 | +9% | 135,611 | 6 | 26% |
| ID — Idaho | $104.58 | +8% | 245,376 | 45 | 15% |
| NE — Nebraska | $100.81 | +4% | 275,809 | 27 | 9% |
| TX — Texas | $100.51 | +4% | 1,400,381 | 116 | 27% |
| ME — Maine | $97.11 | −0% | 1,250,584 | 72 | 38% |
| MI — Michigan | $93.04 | −4% | 39,306,202 | 614 | 28% |
| VT — Vermont | $91.98 | −5% | 1,473,258 | 19 | 24% |
| NH — New Hampshire | $91.63 | −6% | 431,546 | 27 | 40% |
| KY — Kentucky | $84.44 | −13% | 1,352,420 | 195 | 23% |
| IL — Illinois | $82.11 | −15% | 7,089,672 | 433 | 11% |
| AZ — Arizona | $75.50 | −22% | 193,496 | 16 | 27% |
| AR — Arkansas | $74.39 | −23% | 806,019 | 157 | 19% |
| WI — Wisconsin | $73.01 | −25% | 75,970 | 4 | 15% |
| GA — Georgia | $68.95 | −29% | 300,559 | 40 | 5% |
| ND — North Dakota | $60.86 | −37% | 11,112 | 7 | 27% |
| MS — Mississippi | $59.33 | −39% | 1,244,070 | 34 | 21% |
| VA — Virginia | $58.88 | −39% | 9,616 | 3 | 26% |
| MT — Montana | $58.47 | −40% | 27,969 | 4 | 44% |
| LA — Louisiana | $58.22 | −40% | 19,532 | 3 | 20% |
| MO — Missouri | $50.54 | −48% | 890,877 | 18 | 35% |
| WV — West Virginia | $49.41 | −49% | 193,251 | 6 | 24% |
| FL — Florida | $35.34 | −64% | 33,081 | 10 | 17% |
| OK — Oklahoma | $35.11 | −64% | 316,704 | 152 | 20% |
| HI — Hawaii | $34.28 | −65% | 573,528 | 31 | 17% |
| WA — Washington | $19.39 | −80% | 2,020,270 | 141 | 14% |
| NV — Nevada | $0.00 | −100% | 42 | 1 | 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.