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 41 reporting states. National median $55.60. Kentucky pays $53.20, 4% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| WV — West Virginia | $333.35 | +500% | 1,426,975 | 72 | 24% |
| PA — Pennsylvania | $177.71 | +220% | 93,684 | 4 | 16% |
| DE — Delaware | $134.28 | +142% | 3,953,018 | 62 | 22% |
| WI — Wisconsin | $126.45 | +127% | 156,302 | 57 | 15% |
| DC — District of Columbia | $115.41 | +108% | 10,643 | 4 | 27% |
| IL — Illinois | $113.09 | +103% | 1,228,881 | 70 | 11% |
| CA — California | $99.97 | +80% | 319,407 | 40 | 17% |
| RI — Rhode Island | $96.20 | +73% | 673,198 | 34 | 35% |
| WY — Wyoming | $94.94 | +71% | 1,546 | 5 | 19% |
| NJ — New Jersey | $94.24 | +69% | 30,556 | 4 | 36% |
| MA — Massachusetts | $92.05 | +66% | 6,721,982 | 163 | 37% |
| HI — Hawaii | $90.16 | +62% | 714,909 | 83 | 17% |
| AR — Arkansas | $88.37 | +59% | 271,882 | 3 | 19% |
| CO — Colorado | $83.29 | +50% | 4,877,146 | 344 | 31% |
| AZ — Arizona | $79.40 | +43% | 66,973 | 14 | 27% |
| GA — Georgia | $71.83 | +29% | 124,561 | 1 | 5% |
| SD — South Dakota | $71.36 | +28% | 408,662 | 48 | 35% |
| MD — Maryland | $64.33 | +16% | 3,349 | 1 | 21% |
| NY — New York | $61.64 | +11% | 3,829,096 | 36 | 29% |
| KS — Kansas | $56.60 | +2% | 38,249 | 8 | 30% |
| CT — Connecticut | $55.60 | −0% | 29,966 | 1 | 41% |
| KY — Kentucky | $53.20 | −4% | 23,810 | 4 | 23% |
| NH — New Hampshire | $50.98 | −8% | 108,745 | 23 | 40% |
| NV — Nevada | $50.86 | −9% | 122,760 | 61 | 22% |
| ME — Maine | $50.37 | −9% | 2,182 | 1 | 38% |
| IN — Indiana | $48.93 | −12% | 333,906 | 57 | 15% |
| UT — Utah | $46.70 | −16% | 32,758 | 4 | 16% |
| MN — Minnesota | $42.02 | −24% | 5,904,957 | 245 | 24% |
| IA — Iowa | $40.67 | −27% | 385,845 | 80 | 23% |
| FL — Florida | $36.86 | −34% | 39,288,729 | 1,074 | 17% |
| TX — Texas | $35.21 | −37% | 62,181 | 1 | 27% |
| MI — Michigan | $35.01 | −37% | 5,941,532 | 1 | 28% |
| AL — Alabama | $30.91 | −44% | 2,806,581 | 51 | 21% |
| ND — North Dakota | $29.08 | −48% | 17,824 | 2 | 27% |
| MO — Missouri | $26.64 | −52% | 1,071,581 | 90 | 35% |
| MT — Montana | $26.13 | −53% | 49,538 | 9 | 44% |
| ID — Idaho | $23.23 | −58% | 1,781,774 | 77 | 15% |
| OH — Ohio | $22.86 | −59% | 229,363 | 20 | 23% |
| NC — North Carolina | $21.95 | −61% | 24,154 | 3 | 24% |
| SC — South Carolina | $19.69 | −65% | 3,232,660 | 78 | 19% |
| WA — Washington | $1.52 | −97% | 266 | 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.