Medical bills paid by private insurance vs. Medicare: Comparison by state

Private insurance plans in the U.S. paid 248 percent of what Medicare would have paid for the same medical services in 2020, the 2022 National Hospital Price Transparency Study by Rand found.

The study analyzed the average allowed amount paid by a commercial insurance plan compared to what Medicare would have paid for the same services by state. It includes inpatient and outpatient facilities, as well as inpatient and outpatient physician/professional services. 

This data is included in a new dashboard called Sage Transparency, which was launched by the Employers' Forum of Indiana.

Prices paid by commercial health insurance plans relative to Medicare by state:

Note: Data for Maryland is unavailable.

1. South Carolina: 321 percent

2. West Virginia: 317 percent

3. Florida: 309 percent

4. Wisconsin: 307 percent

5. Wyoming: 305 percent

6. Minnesota: 297 percent

7. Indiana: 292 percent (tie)

7. Arizona: 292 percent (tie)

9. Kansas: 290 percent

10. Georgia: 288 percent (tie)

10. New Mexico: 288 percent (tie) 

10. Colorado: 288 percent (tie)

13. California: 286 percent

14. Delaware: 284 percent

15. Nebraska: 282 percent

16. Virginia: 279 percent

17. Alaska: 278 percent (tie)

17. Ohio: 278 percent (tie)

19. Maine: 275 percent

20. North Carolina: 266 percent

21. New York: 263 percent

22. Nevada: 260 percent

23. Missouri: 255 percent

24. Illinois: 253 percent

25. Texas: 252 percent

26. Idaho: 240 percent

27. Montana: 239 percent 

28. Alabama: 235 percent (tie)

28. Pennsylvania: 235 percent (tie)

30. Louisiana: 230 percent 

31. Oregon: 221 percent 

32. Tennessee: 219 percent (tie)

32. Connecticut: 219 percent (tie) 

34. South Dakota: 218 percent (tie) 

34. New Hampshire: 218 percent (tie)

36. New Jersey: 217 percent 

37. Vermont: 215 percent

38. Kentucky: 212 percent 

39. North Dakota: 211 percent 

40. Iowa: 198 percent (tie)

40. Utah: 198 percent (tie)

42. Oklahoma: 195 percent 

43. Rhode Island: 194 percent 

44. Mississippi: 193 percent (tie) 

44. Michigan: 193 percent (tie)

46. Massachusetts: 179 percent 

47. Washington: 174 percent 

48. Arkansas: 149 percent 

49. Hawaii: 147 percent 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars