Prices shown: surgery centers and hospital outpatient departments
Doctor’s fee or facility fee?This mixes two kinds of price: 83% are doctors' fees and 17% 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: Anthem Blue Cross and Blue Shield lists clinicians individually: 88% of the 1,065,071 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. Anthem Blue Cross and Blue Shield’s files name 942,669 providers for this procedure; 102,651 are counted here: the clinicians whose specialty performs it — mostly Internal Medicine, Clinic/Center and Surgery — and the practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so the rest are clinicians listed at a price for something they never do; counting them would inflate the provider count and pull the typical price towards the fee schedule’s floor.
Not on this map: Only part of Anthem is here. These prices come from the files Anthem publishes for members of other Blue plans (BlueCard): its broad network in each state, about 88 GB. Anthem's own index lists roughly 480 more files, about 680 GB, covering some 430 narrower and employer-specific networks across its 14 states. Those have not been read, so a plan that uses one of them may pay different prices from the ones shown. Ohio: Anthem publishes its Ohio prices in the files of its Indiana plan (BlueCard plan 131), which also list many providers in other states (Missouri, Kentucky, Wisconsin, Illinois and more). These maps place every price by where the provider practises: Ohio's are listed as "Anthem Blue Cross and Blue Shield Ohio (filed under its Indiana plan)", Indiana's as Anthem Blue Cross and Blue Shield Indiana, and the rest as "Anthem's Indiana plan: providers outside Indiana and Ohio" - beside those states' own Anthem networks, whose prices differ.
State
Providers
Named in files
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 pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01) — the lower price a doctor is paid when a hospital or surgery center provides the room and equipment. 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. The prices on this map include a facility fee, which Medicare pays separately and which is not in its physician price, so the ratio here runs high and is a rough guide only.
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.