Mapped: Private Insurers Pay Hospitals 2.5 Times What Medicare Pays

For the same care at the same hospitals, employer health plans paid far more than Medicare would have paid. This map shows that gap state by state in 2022, from the RAND Corporation's study of prices paid to more than 4,000 hospitals.

Key Takeaways

- Nationwide, employer plans paid 2.5 times what Medicare would have paid (254% of Medicare).

- Florida was highest, at 3.5 times. West Virginia (3.4), South Carolina (3.3), Wisconsin and Georgia (3.2) followed.

- Arkansas was lowest, at 1.6 times. Mississippi, Michigan, Massachusetts and Rhode Island were also under 2 times.

- The markup was not the same for every part of the bill. In Florida, plans paid 4 times Medicare for outpatient hospital care, 3.2 times for inpatient stays, and 1.8 times for doctors' fees.

Note: Prices are allowed amounts (what the plan and patient together paid) for inpatient and outpatient hospital care, including facility and professional fees, from employer-sponsored plans in the study, compared with what Medicare would have paid the same hospitals for the same services. Covers 49 states and Washington, D.C. Maryland, which sets hospital rates by state law, was not included.