Doctor’s fee or facility fee?This mixes two kinds of price: 89% are doctors' fees and 11% 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: EmblemHealth lists clinicians individually: 98% of the 161,225 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. EmblemHealth’s files name 43,307 providers for this procedure; 14,884 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: Care in New Jersey: for some plans, EmblemHealth rents the QualCare network. Its prices are QualCare's, so they are not included here. Montefiore's doctors and hospitals are missing: the Montefiore file EmblemHealth publishes dates from 2022, is not in the required format, and points to a provider list that is no longer there. These are EmblemHealth's August 2026 files - the newest it had published when this was built. Doctors EmblemHealth pays a flat monthly amount per patient (capitation) have no price per visit. For them its files carry a placeholder of ten cents, marked as a derived amount; those entries are left out, so such doctors may not appear on a map.
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 for the same lab test under its clinical laboratory fee schedule (26CLABQ4, in force from 2026-10-01): one national price, the same in every state. 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.