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 50 reporting states. National median $92.41. District of Columbia pays $139.95, 51% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| DE β Delaware | $452.95 | +390% | 152,754 | 1 | 22% |
| HI β Hawaii | $402.05 | +335% | 2,780 | 8 | 17% |
| WV β West Virginia | $269.51 | +192% | 1,352,801 | 78 | 24% |
| ME β Maine | $223.01 | +141% | 2,298,189 | 110 | 38% |
| CA β California | $190.47 | +106% | 1,024,503 | 56 | 17% |
| OR β Oregon | $188.46 | +104% | 212,599 | 20 | 9% |
| AL β Alabama | $180.38 | +95% | 3,480,879 | 50 | 21% |
| NC β North Carolina | $159.33 | +72% | 942,102 | 86 | 24% |
| CO β Colorado | $154.94 | +68% | 10,731,199 | 476 | 31% |
| RI β Rhode Island | $151.90 | +64% | 1,130,194 | 30 | 35% |
| NY β New York | $148.67 | +61% | 501,693,141 | 912 | 29% |
| VA β Virginia | $148.33 | +61% | 28,207,600 | 760 | 26% |
| DC β District of Columbia | $139.95 | +51% | 9,848,172 | 29 | 27% |
| NH β New Hampshire | $139.32 | +51% | 2,016,532 | 43 | 40% |
| KY β Kentucky | $137.51 | +49% | 4,110,239 | 51 | 23% |
| MT β Montana | $133.75 | +45% | 4,135,041 | 38 | 44% |
| CT β Connecticut | $130.56 | +41% | 154,154 | 1 | 41% |
| ND β North Dakota | $114.79 | +24% | 134,676 | 20 | 27% |
| MD β Maryland | $111.46 | +21% | 805,588 | 4 | 21% |
| PA β Pennsylvania | $110.06 | +19% | 3,146,119 | 86 | 16% |
| IL β Illinois | $106.56 | +15% | 28,775 | 19 | 11% |
| UT β Utah | $105.36 | +14% | 300,142 | 29 | 16% |
| WA β Washington | $102.06 | +10% | 1,303 | 2 | 14% |
| MS β Mississippi | $95.15 | +3% | 14,824,120 | 171 | 21% |
| KS β Kansas | $93.48 | +1% | 5,024,349 | 55 | 30% |
| WY β Wyoming | $91.35 | β1% | 97,228 | 24 | 19% |
| NJ β New Jersey | $89.45 | β3% | 47,411,549 | 274 | 36% |
| TN β Tennessee | $88.13 | β5% | 8,625,534 | 207 | 26% |
| MA β Massachusetts | $86.95 | β6% | 97,006,771 | 138 | 37% |
| GA β Georgia | $86.37 | β7% | 2,728,236 | 34 | 5% |
| SD β South Dakota | $83.10 | β10% | 355,051 | 33 | 35% |
| MO β Missouri | $82.75 | β10% | 74,327,197 | 1,335 | 35% |
| NV β Nevada | $80.61 | β13% | 9,332,701 | 219 | 22% |
| ID β Idaho | $75.60 | β18% | 2,681,420 | 101 | 15% |
| AK β Alaska | $73.80 | β20% | 2,445,804 | 30 | 37% |
| MI β Michigan | $73.17 | β21% | 16,879,628 | 63 | 28% |
| MN β Minnesota | $71.42 | β23% | 26,953,470 | 226 | 24% |
| NM β New Mexico | $70.07 | β24% | 16,902,706 | 89 | 31% |
| OH β Ohio | $68.40 | β26% | 37,721,130 | 830 | 23% |
| SC β South Carolina | $65.99 | β29% | 6,713,175 | 97 | 19% |
| LA β Louisiana | $64.63 | β30% | 18,221,198 | 395 | 20% |
| AR β Arkansas | $64.39 | β30% | 5,469,453 | 139 | 19% |
| IA β Iowa | $57.65 | β38% | 375,456 | 49 | 23% |
| WI β Wisconsin | $54.61 | β41% | 2,114,117 | 46 | 15% |
| FL β Florida | $52.04 | β44% | 36,718,988 | 763 | 17% |
| OK β Oklahoma | $49.71 | β46% | 724,085 | 3 | 20% |
| NE β Nebraska | $44.42 | β52% | 529 | 1 | 9% |
| IN β Indiana | $40.08 | β57% | 3,631 | 1 | 15% |
| AZ β Arizona | $29.74 | β68% | 966,072 | 75 | 27% |
| TX β Texas | $25.38 | β73% | 75,769,273 | 1,050 | 27% |
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.