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 45 reporting states. National median $104.61. Rhode Island pays $118.56, 13% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| WV — West Virginia | $745.13 | +612% | 1,760,824 | 43 | 24% |
| FL — Florida | $709.97 | +579% | 28,031 | 6 | 17% |
| HI — Hawaii | $639.03 | +511% | 78,341 | 17 | 17% |
| MS — Mississippi | $336.24 | +221% | 1,676,253 | 18 | 21% |
| MA — Massachusetts | $297.17 | +184% | 626,892 | 40 | 37% |
| SD — South Dakota | $207.25 | +98% | 158,192 | 4 | 35% |
| ND — North Dakota | $178.55 | +71% | 269,602 | 18 | 27% |
| ME — Maine | $160.76 | +54% | 929,490 | 2 | 38% |
| SC — South Carolina | $141.37 | +35% | 92,995 | 7 | 19% |
| LA — Louisiana | $140.40 | +34% | 25,317,714 | 487 | 20% |
| IN — Indiana | $138.43 | +32% | 1,211,674 | 122 | 15% |
| DE — Delaware | $135.01 | +29% | 738,053 | 23 | 22% |
| MN — Minnesota | $132.55 | +27% | 1,055,116 | 27 | 24% |
| OR — Oregon | $131.47 | +26% | 188,416 | 19 | 9% |
| AZ — Arizona | $123.35 | +18% | 28,112,109 | 224 | 27% |
| RI — Rhode Island | $118.56 | +13% | 5,489,418 | 83 | 35% |
| AL — Alabama | $114.40 | +9% | 14,708 | 1 | 21% |
| TN — Tennessee | $113.71 | +9% | 5,306,023 | 154 | 26% |
| ID — Idaho | $111.87 | +7% | 936,034 | 45 | 15% |
| AK — Alaska | $107.57 | +3% | 1,048,907 | 21 | 37% |
| KS — Kansas | $105.96 | +1% | 11,007,706 | 197 | 30% |
| OH — Ohio | $105.33 | +1% | 4,921 | 2 | 23% |
| NM — New Mexico | $104.61 | −0% | 1,829,612 | 45 | 31% |
| NC — North Carolina | $102.68 | −2% | 11,556,358 | 400 | 24% |
| KY — Kentucky | $100.02 | −4% | 135,546 | 6 | 23% |
| NY — New York | $96.84 | −7% | 3,573,430 | 61 | 29% |
| MT — Montana | $91.19 | −13% | 33,244 | 6 | 44% |
| MO — Missouri | $90.41 | −14% | 468,658 | 5 | 35% |
| GA — Georgia | $86.62 | −17% | 5,515,063 | 4 | 5% |
| PA — Pennsylvania | $85.41 | −18% | 565,182 | 4 | 16% |
| AR — Arkansas | $80.39 | −23% | 1,625,337 | 75 | 19% |
| IA — Iowa | $72.64 | −31% | 973,393 | 85 | 23% |
| UT — Utah | $69.65 | −33% | 57,590 | 13 | 16% |
| MI — Michigan | $64.53 | −38% | 4,067,945 | 1 | 28% |
| CT — Connecticut | $60.54 | −42% | 4,944 | 1 | 41% |
| NE — Nebraska | $59.45 | −43% | 2,380 | 2 | 9% |
| TX — Texas | $58.77 | −44% | 270,947,411 | 1,680 | 27% |
| NV — Nevada | $57.62 | −45% | 41,888 | 9 | 22% |
| WY — Wyoming | $55.87 | −47% | 38,382 | 8 | 19% |
| IL — Illinois | $51.81 | −50% | 15,332 | 2 | 11% |
| NJ — New Jersey | $15.37 | −85% | 52,138 | 6 | 36% |
| WI — Wisconsin | $11.88 | −89% | 8,104,513 | 296 | 15% |
| CA — California | $0.00 | −100% | 209,369 | 4 | 17% |
| CO — Colorado | $0.00 | −100% | 1,336,816 | 36 | 31% |
| WA — Washington | $0.00 | −100% | 57 | 1 | 14% |
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.