Medical malpractice lawsuits paid out more in New York last year than in any other state — and by a huge margin.

Awards in malpractice lawsuits paid out roughly $690 million in New York last year, nearly twice that of second-ranked Pennsylvania, which saw $357 million in payouts, according to government data compiled by Jeremy Gower of Diederich Healthcare, a medical malpractice insurer. New York is also the clear leader on per capita payouts, averaging $39 per resident with Pennsylvania trailing at $25 per resident.

Malpractice lawsuits have long prompted controversy among policymakers. Some argue they drive up insurance rates and make it difficult to be a physician while others say they’re necessary to protect consumers. This past Thursday, the Florida Supreme Court said the state legislature manufactured an “alleged medical malpractice crisis” and threw out limits on payouts in some wrongful death lawsuits, according to the Miami Herald. And lawyers and industry groups are collecting signatures to get a measure to increase the cap on the ballot in California.

Caps on malpractice awards have been overturned in at least nine other states, according to year-old data from PIAA, an insurance industry trade association. And only 15 states lack caps altogether. (New York and Pennsylvania are among them, according to the American College of Emergency Physicians.)

Payouts overall rose 4.7 percent between 2012 and 2013 to $3.7 billion, according to Gower’s compilation of government data. The map above and charts below came from his graphic, which includes a lot more info on malpractice suits.

CORRECTION: An earlier version of this post incorrectly stated the total malpractice payouts from 2013. Some $3.7 billion were awarded last year.