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|Charges Billed by Out-of-Network Providers: Implications for Affordability|
America's Health Insurance Plans [AHIP]
Oct. 1, 2015
"[This] study identified a pattern of average billed charges submitted by out-of-network providers that far exceeded Medicare reimbursement for the same service performed in the same geographic area.... There was wide variation in out-of-network charges from different providers for the same procedure.... For many procedures, [the authors] found regional patterns in the ratio of out-of-network charges to average Medicare fee at the state level."
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