Lancashire has topped the league of overtime payments to consultants - with one doctor earning £375,999, on top of their annual salary.
Lancashire Teaching Hospitals Trust - which runs Royal Preston and Chorley and South Ribble hospitals - had the consultant paid the highest amount of overtime payments.
Blackpool Teaching Hospitals had the third highest payment, with one consultant paid £183,204 in 2015/16, on top of their normal salary.
Spending on premium-rate overtime by hospitals has risen by more than a third in the past two years, a Freedom of Information request has found.
Hospitals can pay consultants a higher-than-normal rate for extra shifts.
Some hospitals have paid up to £1,000 for four hours’ work, research by the BBC found, while rates of £600 a shift is common - three or four times consultants’ normal rate of pay.
The average amount paid in high-cost overtime last year was £13,356 per consultant.
Figures from 114 of the 186 trusts and health boards show the amount hospitals spend on high-cost overtime is increasing.
In 2015-16, £168m was spent, up from £125m in 2013-14.
The British Medical Association (BMA) said the payments were a sign of doctor shortages.
Keith Brent, the BMA consultants’ leader, said: “These payments are made because there simply are not enough doctors and hospitals are under pressure to meet waiting time targets.”
But not all hospitals pay overtime at higher rates.
Wrightington, Wigan and Leigh NHS Foundation Trust stopped paying premium rates in 2010.
Andrew Foster, the trust’s chief executive, told the BBC: “I don’t think it is very defensible to pay a huge premium to one group of staff and not to other groups of staff.”