Multiple Sources · 56 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).
- 2American Samoa ranks last at $8,913, while Massachusetts leads at $21,636.
- 3The national median across all states is $14,858 (Ohio 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 2023 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 | Virgin Islands | $12,142 | 2 |
| 7 | Vermont | $15,274 | 17 |
| 8 | Utah | $15,877 | 51 |
| 9 | Texas | $15,897 | 465 |
| 10 | Tennessee | $14,163 | 122 |
| 11 | South Dakota | $13,386 | 61 |
| 12 | South Carolina | $14,688 | 66 |
| 13 | Rhode Island | $18,442 | 13 |
| 14 | Puerto Rico | $10,336 | 61 |
| 15 | Pennsylvania | $16,898 | 188 |
| 16 | Oregon | $16,874 | 62 |
| 17 | Oklahoma | $12,911 | 135 |
| 18 | Ohio | $14,858 | 196 |
| 19 | Northern Mariana Islands | $9,415 | 1 |
| 20 | North Dakota | $14,386 | 47 |
| 21 | North Carolina | $14,777 | 120 |
| 22 | New York | $21,448 | 190 |
| 23 | New Mexico | $14,678 | 45 |
| 24 | New Jersey | $20,736 | 79 |
| 25 | New Hampshire | $16,578 | 28 |
| 26 | Nevada | $16,777 | 46 |
| 27 | Nebraska | $13,235 | 93 |
| 28 | Montana | $13,252 | 63 |
| 29 | Missouri | $13,821 | 121 |
| 30 | Mississippi | $12,292 | 106 |
| 31 | Minnesota | $14,886 | 136 |
| 32 | Michigan | $14,885 | 148 |
| 33 | Massachusetts | $21,636 | 84 |
| 34 | Maryland | $18,626 | 56 |
| 35 | Maine | $15,047 | 36 |
| 36 | Louisiana | $14,492 | 161 |
| 37 | Kentucky | $13,644 | 102 |
| 38 | Kansas | $13,528 | 138 |
| 39 | Iowa | $12,512 | 118 |
| 40 | Indiana | $13,977 | 150 |
| 41 | Illinois | $16,459 | 194 |
| 42 | Idaho | $13,935 | 48 |
| 43 | Hawaii | $20,551 | 24 |
| 44 | Guam | $10,650 | 2 |
| 45 | Georgia | $15,003 | 148 |
| 46 | Florida | $16,859 | 222 |
| 47 | District of Columbia | $20,781 | 10 |
| 48 | Delaware | $16,693 | 13 |
| 49 | Connecticut | $18,954 | 37 |
| 50 | Colorado | $16,841 | 97 |
| 51 | California | $21,491 | 378 |
| 52 | Arkansas | $13,359 | 90 |
| 53 | Arizona | $16,036 | 106 |
| 54 | American Samoa | $8,913 | 1 |
| 55 | Alaska | $20,163 | 25 |
| 56 | Alabama | $13,264 | 102 |
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
Massachusetts has the highest average hospital payment at $21,636, according to Census ACS 2023 data. California and New York round out the top three.
American Samoa has the lowest average hospital payment at $8,913. Northern Mariana Islands is second-lowest at $9,415.
The median across all 56 states is $14,858. 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.