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 46 reporting states. National median $72.63. Indiana pays $41.01, 44% below the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| NM — New Mexico | $373.66 | +414% | 47,952 | 6 | 31% |
| OR — Oregon | $372.22 | +412% | 167,308 | 44 | 9% |
| VA — Virginia | $334.69 | +361% | 1,289,598 | 46 | 26% |
| MI — Michigan | $213.49 | +194% | 6,624,495 | 175 | 28% |
| MN — Minnesota | $207.92 | +186% | 456,022 | 25 | 24% |
| CA — California | $175.94 | +142% | 14,939,275 | 631 | 17% |
| IA — Iowa | $155.86 | +115% | 204,808 | 18 | 23% |
| NJ — New Jersey | $151.03 | +108% | 893,120 | 45 | 36% |
| NC — North Carolina | $150.28 | +107% | 1,838,752 | 216 | 24% |
| NV — Nevada | $149.17 | +105% | 2,251,212 | 50 | 22% |
| MD — Maryland | $145.41 | +100% | 463,547 | 24 | 21% |
| DE — Delaware | $120.12 | +65% | 11,365 | 1 | 22% |
| MA — Massachusetts | $110.34 | +52% | 149,106 | 25 | 37% |
| WI — Wisconsin | $103.24 | +42% | 1,707,681 | 87 | 15% |
| LA — Louisiana | $102.08 | +41% | 78,393 | 10 | 20% |
| CT — Connecticut | $97.71 | +35% | 434,822 | 22 | 41% |
| PA — Pennsylvania | $96.08 | +32% | 6,152,149 | 205 | 16% |
| AZ — Arizona | $95.17 | +31% | 3,761 | 3 | 27% |
| TX — Texas | $94.46 | +30% | 3,153,670 | 219 | 27% |
| IL — Illinois | $93.74 | +29% | 1,106,258 | 27 | 11% |
| ME — Maine | $85.09 | +17% | 1,255,071 | 105 | 38% |
| RI — Rhode Island | $75.02 | +3% | 79,755 | 24 | 35% |
| CO — Colorado | $74.96 | +3% | 2,040,371 | 313 | 31% |
| DC — District of Columbia | $70.31 | −3% | 30,681 | 24 | 27% |
| UT — Utah | $69.39 | −4% | 940,946 | 61 | 16% |
| ND — North Dakota | $68.50 | −6% | 59,624 | 16 | 27% |
| ID — Idaho | $61.46 | −15% | 697,792 | 189 | 15% |
| MS — Mississippi | $58.90 | −19% | 710,681 | 42 | 21% |
| SC — South Carolina | $53.44 | −26% | 1,292,855 | 57 | 19% |
| OH — Ohio | $53.37 | −27% | 599 | 2 | 23% |
| FL — Florida | $53.28 | −27% | 15,974,144 | 578 | 17% |
| AL — Alabama | $45.23 | −38% | 187,527 | 72 | 21% |
| KS — Kansas | $44.43 | −39% | 2,940,965 | 218 | 30% |
| WY — Wyoming | $43.25 | −40% | 28,124 | 21 | 19% |
| IN — Indiana | $41.01 | −44% | 36,160 | 2 | 15% |
| TN — Tennessee | $36.68 | −50% | 103,484 | 4 | 26% |
| NY — New York | $32.81 | −55% | 4,092,597 | 239 | 29% |
| MO — Missouri | $31.98 | −56% | 19,410 | 6 | 35% |
| KY — Kentucky | $31.61 | −56% | 107 | 2 | 23% |
| OK — Oklahoma | $30.00 | −59% | 846,445 | 291 | 20% |
| WA — Washington | $25.86 | −64% | 233,102 | 81 | 14% |
| VT — Vermont | $25.18 | −65% | 77,633 | 19 | 24% |
| WV — West Virginia | $23.72 | −67% | 449,777 | 112 | 24% |
| HI — Hawaii | $23.03 | −68% | 51,814 | 2 | 17% |
| AR — Arkansas | $21.50 | −70% | 873,575 | 90 | 19% |
| GA — Georgia | $16.41 | −77% | 56 | 1 | 5% |
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.