What each state pays for the same procedure. Start from a code β 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.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| NM β New Mexico | $373.66 | +414% | 47,952 | 6 | 31% |
| OR β Oregon | $372.22 | +412% | 167,308 | 44 | 9% |
| VA β Virginia | $334.69 | +361% | 1,289,598 | 46 | 26% |
| MI β Michigan | $213.49 | +194% | 6,624,495 | 175 | 28% |
| MN β Minnesota | $207.92 | +186% | 456,022 | 25 | 24% |
| CA β California | $175.94 | +142% | 14,939,275 | 631 | 17% |
| IA β Iowa | $155.86 | +115% | 204,808 | 18 | 23% |
| NJ β New Jersey | $151.03 | +108% | 893,120 | 45 | 36% |
| NC β North Carolina | $150.28 | +107% | 1,838,752 | 216 | 24% |
| NV β Nevada | $149.17 | +105% | 2,251,212 | 50 | 22% |
| MD β Maryland | $145.41 | +100% | 463,547 | 24 | 21% |
| DE β Delaware | $120.12 | +65% | 11,365 | 1 | 22% |
| MA β Massachusetts | $110.34 | +52% | 149,106 | 25 | 37% |
| WI β Wisconsin | $103.24 | +42% | 1,707,681 | 87 | 15% |
| LA β Louisiana | $102.08 | +41% | 78,393 | 10 | 20% |
| CT β Connecticut | $97.71 | +35% | 434,822 | 22 | 41% |
| PA β Pennsylvania | $96.08 | +32% | 6,152,149 | 205 | 16% |
| AZ β Arizona | $95.17 | +31% | 3,761 | 3 | 27% |
| TX β Texas | $94.46 | +30% | 3,153,670 | 219 | 27% |
| IL β Illinois | $93.74 | +29% | 1,106,258 | 27 | 11% |
| ME β Maine | $85.09 | +17% | 1,255,071 | 105 | 38% |
| RI β Rhode Island | $75.02 | +3% | 79,755 | 24 | 35% |
| CO β Colorado | $74.96 | +3% | 2,040,371 | 313 | 31% |
| DC β District of Columbia | $70.31 | β3% | 30,681 | 24 | 27% |
| UT β Utah | $69.39 | β4% | 940,946 | 61 | 16% |
| ND β North Dakota | $68.50 | β6% | 59,624 | 16 | 27% |
| ID β Idaho | $61.46 | β15% | 697,792 | 189 | 15% |
| MS β Mississippi | $58.90 | β19% | 710,681 | 42 | 21% |
| SC β South Carolina | $53.44 | β26% | 1,292,855 | 57 | 19% |
| OH β Ohio | $53.37 | β27% | 599 | 2 | 23% |
| FL β Florida | $53.28 | β27% | 15,974,144 | 578 | 17% |
| AL β Alabama | $45.23 | β38% | 187,527 | 72 | 21% |
| KS β Kansas | $44.43 | β39% | 2,940,965 | 218 | 30% |
| WY β Wyoming | $43.25 | β40% | 28,124 | 21 | 19% |
| IN β Indiana | $41.01 | β44% | 36,160 | 2 | 15% |
| TN β Tennessee | $36.68 | β50% | 103,484 | 4 | 26% |
| NY β New York | $32.81 | β55% | 4,092,597 | 239 | 29% |
| MO β Missouri | $31.98 | β56% | 19,410 | 6 | 35% |
| KY β Kentucky | $31.61 | β56% | 107 | 2 | 23% |
| OK β Oklahoma | $30.00 | β59% | 846,445 | 291 | 20% |
| WA β Washington | $25.86 | β64% | 233,102 | 81 | 14% |
| VT β Vermont | $25.18 | β65% | 77,633 | 19 | 24% |
| WV β West Virginia | $23.72 | β67% | 449,777 | 112 | 24% |
| HI β Hawaii | $23.03 | β68% | 51,814 | 2 | 17% |
| AR β Arkansas | $21.50 | β70% | 873,575 | 90 | 19% |
| GA β Georgia | $16.41 | β77% | 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 stateβs program these claims represent.