Multiple Sources · 52 states
States With Most Expensive Hospital Care
Hospital costs vary enormously across the United States, driven by differences in labor costs, market concentration, cost of living, and procedure mix. States with the most expensive hospital care combine high labor costs with limited hospital competition. The average payment per procedure can differ by 2-3x between the most and least expensive states for identical treatments. These disparities affect everyone: insured patients through higher premiums, and uninsured patients who face full charges. Hospital cost variation reveals how market structure, regulation, and geographic factors drive healthcare spending -- the largest single expense in the US economy.
Key Findings
- 1Massachusetts leads with a average hospital payment of $21,636, followed by California ($21,491) and New York ($21,448).
- 2Puerto Rico ranks last at $10,336, while Massachusetts leads at $21,636.
- 3The national median across all states is $14,886 (Minnesota at the midpoint).
- 4The top 10 states are: Massachusetts, California, New York, District of Columbia, New Jersey, Hawaii, Alaska, Connecticut, Maryland, Rhode Island.
Full Ranking: States With Most Expensive Hospital Care
Source: Census ACS 5-Year Estimates
| # | State | Avg Payment | Hospitals |
|---|---|---|---|
| 1 | Wyoming | $13,165 | 30 |
| 2 | Wisconsin | $14,497 | 142 |
| 3 | West Virginia | $11,835 | 55 |
| 4 | Washington | $17,541 | 100 |
| 5 | Virginia | $17,397 | 95 |
| 6 | Vermont | $15,274 | 17 |
| 7 | Utah | $15,877 | 51 |
| 8 | Texas | $15,897 | 465 |
| 9 | Tennessee | $14,163 | 122 |
| 10 | South Dakota | $13,386 | 61 |
| 11 | South Carolina | $14,688 | 66 |
| 12 | Rhode Island | $18,442 | 13 |
| 13 | Puerto Rico | $10,336 | 61 |
| 14 | Pennsylvania | $16,898 | 188 |
| 15 | Oregon | $16,874 | 62 |
| 16 | Oklahoma | $12,911 | 135 |
| 17 | Ohio | $14,858 | 196 |
| 18 | North Dakota | $14,386 | 47 |
| 19 | North Carolina | $14,777 | 120 |
| 20 | New York | $21,448 | 190 |
| 21 | New Mexico | $14,678 | 45 |
| 22 | New Jersey | $20,736 | 79 |
| 23 | New Hampshire | $16,578 | 28 |
| 24 | Nevada | $16,777 | 46 |
| 25 | Nebraska | $13,235 | 93 |
| 26 | Montana | $13,252 | 63 |
| 27 | Missouri | $13,821 | 121 |
| 28 | Mississippi | $12,292 | 106 |
| 29 | Minnesota | $14,886 | 136 |
| 30 | Michigan | $14,885 | 148 |
| 31 | Massachusetts | $21,636 | 84 |
| 32 | Maryland | $18,626 | 56 |
| 33 | Maine | $15,047 | 36 |
| 34 | Louisiana | $14,492 | 161 |
| 35 | Kentucky | $13,644 | 102 |
| 36 | Kansas | $13,528 | 138 |
| 37 | Iowa | $12,512 | 118 |
| 38 | Indiana | $13,977 | 150 |
| 39 | Illinois | $16,459 | 194 |
| 40 | Idaho | $13,935 | 48 |
| 41 | Hawaii | $20,551 | 24 |
| 42 | Georgia | $15,003 | 148 |
| 43 | Florida | $16,859 | 222 |
| 44 | District of Columbia | $20,781 | 10 |
| 45 | Delaware | $16,693 | 13 |
| 46 | Connecticut | $18,954 | 37 |
| 47 | Colorado | $16,841 | 97 |
| 48 | California | $21,491 | 378 |
| 49 | Arkansas | $13,359 | 90 |
| 50 | Arizona | $16,036 | 106 |
| 51 | Alaska | $20,163 | 25 |
| 52 | Alabama | $13,264 | 102 |
Methodology
Rankings are based on American Community Survey (ACS) 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
Massachusetts has the highest average hospital payment at $21,636, according to latest Census ACS data. California and New York round out the top three.
Puerto Rico has the lowest average hospital payment at $10,336. West Virginia is second-lowest at $11,835.
The median across all 52 states is $14,886. 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) 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 5-Year estimates. The Census Bureau releases new ACS data annually. Our data was last updated on April 12, 2026.
Rankings are based on American Community Survey (ACS) 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.
Source: U.S. Census Bureau ACS, 2026.