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Population Review

Multiple Sources · 56 states

States With Most Affordable Hospital Care

States with the most affordable hospital care tend to be in the South and Midwest, where lower labor costs, more competitive hospital markets, and lower costs of living combine to reduce procedure prices. However, lower prices don't always mean better access -- rural areas in these states may have limited hospital options, requiring patients to travel long distances. The relationship between cost and quality is complex: some of the cheapest hospitals deliver excellent outcomes, while some of the most expensive provide mediocre care. Hospital cost transparency has become a major policy priority, with federal regulations now requiring hospitals to publish pricing data.

Key Findings

  • 1American Samoa leads with a average hospital payment of $8,913, followed by Northern Mariana Islands ($9,415) and Puerto Rico ($10,336).
  • 2Massachusetts ranks last at $21,636, while American Samoa leads at $8,913.
  • 3The national median across all states is $14,885 (Michigan at the midpoint).
  • 4The top 10 states are: American Samoa, Northern Mariana Islands, Puerto Rico, Guam, West Virginia, Virgin Islands, Mississippi, Iowa, Oklahoma, Wyoming.

Full Ranking: States With Most Affordable Hospital Care

Source: Census ACS 2023 5-Year Estimates

#StateAvg PaymentHospitals
1Wyoming$13,16530
2Wisconsin$14,497142
3West Virginia$11,83555
4Washington$17,541100
5Virginia$17,39795
6Virgin Islands$12,1422
7Vermont$15,27417
8Utah$15,87751
9Texas$15,897465
10Tennessee$14,163122
11South Dakota$13,38661
12South Carolina$14,68866
13Rhode Island$18,44213
14Puerto Rico$10,33661
15Pennsylvania$16,898188
16Oregon$16,87462
17Oklahoma$12,911135
18Ohio$14,858196
19Northern Mariana Islands$9,4151
20North Dakota$14,38647
21North Carolina$14,777120
22New York$21,448190
23New Mexico$14,67845
24New Jersey$20,73679
25New Hampshire$16,57828
26Nevada$16,77746
27Nebraska$13,23593
28Montana$13,25263
29Missouri$13,821121
30Mississippi$12,292106
31Minnesota$14,886136
32Michigan$14,885148
33Massachusetts$21,63684
34Maryland$18,62656
35Maine$15,04736
36Louisiana$14,492161
37Kentucky$13,644102
38Kansas$13,528138
39Iowa$12,512118
40Indiana$13,977150
41Illinois$16,459194
42Idaho$13,93548
43Hawaii$20,55124
44Guam$10,6502
45Georgia$15,003148
46Florida$16,859222
47District of Columbia$20,78110
48Delaware$16,69313
49Connecticut$18,95437
50Colorado$16,84197
51California$21,491378
52Arkansas$13,35990
53Arizona$16,036106
54American Samoa$8,9131
55Alaska$20,16325
56Alabama$13,264102

Methodology

Rankings are based on American Community Survey (ACS) 2023 5-Year estimates from the US Census Bureau. All 50 states and the District of Columbia are included. The ACS surveys approximately 3.5 million households annually and provides detailed demographic, social, economic, and housing data. 5-Year estimates offer the most reliable data for state-level comparisons by averaging responses over a 60-month period. Percentages may not sum to 100% due to rounding.

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Frequently Asked Questions

American Samoa has the highest average hospital payment at $8,913, according to Census ACS 2023 data. Northern Mariana Islands and Puerto Rico round out the top three.

Massachusetts has the lowest average hospital payment at $21,636. California is second-lowest at $21,491.

The median across all 56 states is $14,885. Note that the national median and the state-level median are calculated differently — the state median represents the midpoint when all states are ranked.

This data comes from the American Community Survey (ACS) 2023 5-Year estimates published by the US Census Bureau. The ACS surveys approximately 3.5 million households annually and provides the most comprehensive demographic data available between decennial censuses.

Rankings are based on the latest available Census ACS data (currently 2023 5-Year estimates). The Census Bureau releases new ACS data annually, typically in September. Our data was last updated on April 12, 2026.

Rankings are based on American Community Survey (ACS) 2023 5-Year estimates from the US Census Bureau. All 50 states and the District of Columbia are included. The ACS surveys approximately 3.5 million households annually and provides detailed demographic, social, economic, and housing data. 5-Year estimates offer the most reliable data for state-level comparisons by averaging responses over a 60-month period. Percentages may not sum to 100% due to rounding.