Doctor’s fee or facility fee?This mixes two kinds of price: 21% are doctors' fees and 79% are facility fees paid to a hospital or surgery center. Facility fees are usually far higher, so a wide spread can be the two kinds side by side, not providers charging wildly different amounts. Either way, expect a doctor's fee and a facility fee as separate bills when this is done in a hospital or surgery center. Where a state has both, the table and each state’s popup show the doctor’s fee and the facility fee side by side; their sum is a rough total for the visit, before anything else done during it.
Who is counted: Aetna lists clinicians individually: 85% of the 2,390,616 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
Not on this map: Prices found in only some copies of a network: Aetna's files repeat themselves heavily, so each group of nearly identical files was read once, through one of its files. On the largest group (1,177 files) the files shared 98-99.9% of their prices; the rest is not shown. Plans that fit none of Aetna's named products: 19 of the files read serve plans whose names say no product, and their prices are shown under "Aetna (other plans)".
State
Providers
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
Doctor’s fee
Facility fee
vs Medicare
“x Medicare” compares each price with what original Medicare actually paid hospitals in the same state for the same kind of stay in 2024, the newest year it has published: the average per stay, the patient’s share included, at hospitals with more than ten such stays. Medicare’s payment varies by hospital (wages, teaching, low-income patients), so this is a state average, not any one hospital’s rate. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.
This is a statewide summary. Prices vary far more between towns and between practices than these medians suggest; zip-code and provider-level detail is not published here; this specific data can be requested here.