Doctor’s fee or facility fee?This mixes two kinds of price: 15% are doctors' fees and 85% 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: CareSource lists clinicians individually: 96% of the 201,059 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. CareSource’s files name 126,175 providers for this procedure; 64,905 are counted here: the clinicians whose specialty performs it — mostly Nurse Practitioner, Physician Assistant and Internal Medicine — 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: CareSource labels almost every price in its files as a facility ("institutional") price, office visits included. The amounts match what a doctor's visit normally costs, so read the doctor's-fee / facility-fee label on these pages with caution. CareSource publishes no prices for hospital stays in these files. Its files are for its Marketplace (individual) plans; plans for CareSource's own employees are published by UnitedHealthcare and are not included. Hospital stays: CareSource's files have no prices for whole hospital stays (the kind billed as one amount per stay), so there are no hospital-stay maps for it. It may pay hospitals by the day or as a share of their charges, which these maps cannot show.
State
Providers
Named in files
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
Doctor’s fee
Facility fee
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.