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 50 reporting states. National median $92.41. Maryland pays $111.46, 21% above the median.
State-by-state detail is in the table below.
| State | Avg paid / claim | vs median | Claims | Providers | Coverage |
|---|---|---|---|---|---|
| DE — Delaware | $452.95 | +390% | 152,754 | 1 | 22% |
| HI — Hawaii | $402.05 | +335% | 2,780 | 8 | 17% |
| WV — West Virginia | $269.51 | +192% | 1,352,801 | 78 | 24% |
| ME — Maine | $223.01 | +141% | 2,298,189 | 110 | 38% |
| CA — California | $190.47 | +106% | 1,024,503 | 56 | 17% |
| OR — Oregon | $188.46 | +104% | 212,599 | 20 | 9% |
| AL — Alabama | $180.38 | +95% | 3,480,879 | 50 | 21% |
| NC — North Carolina | $159.33 | +72% | 942,102 | 86 | 24% |
| CO — Colorado | $154.94 | +68% | 10,731,199 | 476 | 31% |
| RI — Rhode Island | $151.90 | +64% | 1,130,194 | 30 | 35% |
| NY — New York | $148.67 | +61% | 501,693,141 | 912 | 29% |
| VA — Virginia | $148.33 | +61% | 28,207,600 | 760 | 26% |
| DC — District of Columbia | $139.95 | +51% | 9,848,172 | 29 | 27% |
| NH — New Hampshire | $139.32 | +51% | 2,016,532 | 43 | 40% |
| KY — Kentucky | $137.51 | +49% | 4,110,239 | 51 | 23% |
| MT — Montana | $133.75 | +45% | 4,135,041 | 38 | 44% |
| CT — Connecticut | $130.56 | +41% | 154,154 | 1 | 41% |
| ND — North Dakota | $114.79 | +24% | 134,676 | 20 | 27% |
| MD — Maryland | $111.46 | +21% | 805,588 | 4 | 21% |
| PA — Pennsylvania | $110.06 | +19% | 3,146,119 | 86 | 16% |
| IL — Illinois | $106.56 | +15% | 28,775 | 19 | 11% |
| UT — Utah | $105.36 | +14% | 300,142 | 29 | 16% |
| WA — Washington | $102.06 | +10% | 1,303 | 2 | 14% |
| MS — Mississippi | $95.15 | +3% | 14,824,120 | 171 | 21% |
| KS — Kansas | $93.48 | +1% | 5,024,349 | 55 | 30% |
| WY — Wyoming | $91.35 | −1% | 97,228 | 24 | 19% |
| NJ — New Jersey | $89.45 | −3% | 47,411,549 | 274 | 36% |
| TN — Tennessee | $88.13 | −5% | 8,625,534 | 207 | 26% |
| MA — Massachusetts | $86.95 | −6% | 97,006,771 | 138 | 37% |
| GA — Georgia | $86.37 | −7% | 2,728,236 | 34 | 5% |
| SD — South Dakota | $83.10 | −10% | 355,051 | 33 | 35% |
| MO — Missouri | $82.75 | −10% | 74,327,197 | 1,335 | 35% |
| NV — Nevada | $80.61 | −13% | 9,332,701 | 219 | 22% |
| ID — Idaho | $75.60 | −18% | 2,681,420 | 101 | 15% |
| AK — Alaska | $73.80 | −20% | 2,445,804 | 30 | 37% |
| MI — Michigan | $73.17 | −21% | 16,879,628 | 63 | 28% |
| MN — Minnesota | $71.42 | −23% | 26,953,470 | 226 | 24% |
| NM — New Mexico | $70.07 | −24% | 16,902,706 | 89 | 31% |
| OH — Ohio | $68.40 | −26% | 37,721,130 | 830 | 23% |
| SC — South Carolina | $65.99 | −29% | 6,713,175 | 97 | 19% |
| LA — Louisiana | $64.63 | −30% | 18,221,198 | 395 | 20% |
| AR — Arkansas | $64.39 | −30% | 5,469,453 | 139 | 19% |
| IA — Iowa | $57.65 | −38% | 375,456 | 49 | 23% |
| WI — Wisconsin | $54.61 | −41% | 2,114,117 | 46 | 15% |
| FL — Florida | $52.04 | −44% | 36,718,988 | 763 | 17% |
| OK — Oklahoma | $49.71 | −46% | 724,085 | 3 | 20% |
| NE — Nebraska | $44.42 | −52% | 529 | 1 | 9% |
| IN — Indiana | $40.08 | −57% | 3,631 | 1 | 15% |
| AZ — Arizona | $29.74 | −68% | 966,072 | 75 | 27% |
| TX — Texas | $25.38 | −73% | 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 state’s program these claims represent.