Payers shown: Blue Cross and Blue Shield of Illinois, Texas, Oklahoma, New Mexico and Montana (HCSC)
Prices shown: surgery centers and hospital outpatient departments
Doctor’s fee or facility fee? These are doctors' (professional) fees only. If this is done in a hospital or surgery center, the facility bills its own fee on top — for the room, nurses and equipment — often larger than the doctor's. That fee is not included here.
Who is counted: Blue Cross and Blue Shield of Illinois, Texas, Oklahoma, New Mexico and Montana lists clinicians individually: 83% of the 490,047 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. Blue Cross and Blue Shield of Illinois, Texas, Oklahoma, New Mexico and Montana’s files name 195,991 providers for this procedure; 32,120 are counted here: the clinicians whose specialty performs it — mostly Physician Assistant, Clinic/Center and Orthopaedic 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: Care outside its home state: Blue Cross Blue Shield plans share one national network, BlueCard, for members treated in other states. Those prices are published centrally, not by Blue Cross and Blue Shield of Illinois, Texas, Oklahoma, New Mexico and Montana, so they are not included here. Some large-employer plans: HCSC publishes a separate file index for each of about 6,000 self-funded employers. This site reads the five state indexes for insured plans; a sample of the employer indexes pointed at the same network files almost every time, but a few employer-only files are not included.
State
Providers
Named in files
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
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.
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.