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 43 reporting states. National median $444.63. District of Columbia pays $572.10, 29% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| MA — Massachusetts | $10,071.81 | +2165% | 890,807 | 25 | 37% |
| AL — Alabama | $3,837.56 | +763% | 477,625 | 1 | 21% |
| IA — Iowa | $2,087.89 | +370% | 1,585 | 1 | 23% |
| RI — Rhode Island | $1,833.70 | +312% | 13,558 | 5 | 35% |
| ME — Maine | $1,671.26 | +276% | 1,382,496 | 75 | 38% |
| SD — South Dakota | $1,656.46 | +273% | 400,038 | 21 | 35% |
| NH — New Hampshire | $1,554.64 | +250% | 38,025 | 3 | 40% |
| HI — Hawaii | $1,173.92 | +164% | 66,193 | 9 | 17% |
| PA — Pennsylvania | $1,115.92 | +151% | 15,820 | 4 | 16% |
| VA — Virginia | $958.70 | +116% | 9,016 | 5 | 26% |
| UT — Utah | $707.70 | +59% | 427 | 9 | 16% |
| IN — Indiana | $626.92 | +41% | 1,523,511 | 74 | 15% |
| DE — Delaware | $613.28 | +38% | 333,520 | 10 | 22% |
| CA — California | $579.01 | +30% | 5,542 | 2 | 17% |
| MD — Maryland | $578.23 | +30% | 491,222 | 11 | 21% |
| DC — District of Columbia | $572.10 | +29% | 977,108 | 17 | 27% |
| WY — Wyoming | $518.12 | +17% | 386,000 | 19 | 19% |
| NJ — New Jersey | $513.66 | +16% | 7,112 | 2 | 36% |
| MT — Montana | $457.93 | +3% | 70,177 | 10 | 44% |
| WI — Wisconsin | $457.56 | +3% | 250,447 | 5 | 15% |
| MO — Missouri | $450.51 | +1% | 11,562,163 | 193 | 35% |
| NE — Nebraska | $444.63 | −0% | 19,863 | 1 | 9% |
| TN — Tennessee | $428.51 | −4% | 1,244,684 | 44 | 26% |
| NY — New York | $426.77 | −4% | 14,150 | 1 | 29% |
| KS — Kansas | $400.38 | −10% | 4,170,975 | 121 | 30% |
| ND — North Dakota | $397.88 | −11% | 1,025,403 | 29 | 27% |
| ID — Idaho | $384.45 | −14% | 274,505 | 1 | 15% |
| OH — Ohio | $383.93 | −14% | 36,640 | 1 | 23% |
| AK — Alaska | $358.36 | −19% | 1,124,264 | 31 | 37% |
| NM — New Mexico | $358.04 | −19% | 2,468,186 | 40 | 31% |
| NV — Nevada | $342.05 | −23% | 297,796 | 4 | 22% |
| MI — Michigan | $312.48 | −30% | 12,686 | 1 | 28% |
| AZ — Arizona | $311.75 | −30% | 4,542,636 | 28 | 27% |
| CO — Colorado | $291.71 | −34% | 8,183,916 | 193 | 31% |
| IL — Illinois | $278.69 | −37% | 186,227 | 3 | 11% |
| FL — Florida | $264.81 | −40% | 484,000 | 7 | 17% |
| SC — South Carolina | $247.36 | −44% | 3,239,608 | 52 | 19% |
| MN — Minnesota | $242.87 | −45% | 3,352,646 | 34 | 24% |
| TX — Texas | $195.46 | −56% | 4,501,328 | 109 | 27% |
| KY — Kentucky | $193.91 | −56% | 8,542,404 | 146 | 23% |
| NC — North Carolina | $186.62 | −58% | 816,591 | 93 | 24% |
| LA — Louisiana | $34.46 | −92% | 1,846,982 | 75 | 20% |
| VT — Vermont | $0.00 | −100% | 247,099 | 12 | 24% |
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.