Variations in medical spending Medicare expenditures on patients in their last two years of life averaged $46,412 nationwide But tremendous regional variation Medicare spent on average $59,379 per patient in New Jersey,almost double what it spent in North Dakota Average bill in Miami,Florida:$83,504 Average bill in La Crosse,Wisconsin:$36,949 Variation in spending even within the same city Bhattacharya,Hyde and Tu-HealthEconomicsBhattacharya, Hyde and Tu – Health Economics Variations in medical spending  Medicare expenditures on patients in their last two years of life averaged $46,412 nationwide  But tremendous regional variation  Medicare spent on average $59,379 per patient in New Jersey, almost double what it spent in North Dakota  Average bill in Miami, Florida: $83,504  Average bill in La Crosse, Wisconsin: $36,949  Variation in spending even within the same city