Doctor’s fee or facility fee? These are doctors' fees for a visit in their own office. An independent practice usually charges nothing more, but a clinic owned by a hospital may add a separate facility fee — worth asking before you book. (About 9% of these prices are facility fees instead, which can show up as unusually high prices.) 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 45,153 providers for this procedure; 17,181 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
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.