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 facility fees: what the insurer pays the hospital or surgery center itself. The doctors who treat you bill separately, on top of it.
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 22 providers for this procedure; 19 are counted here: the clinicians whose specialty performs it — mostly Psychiatric Unit and General Acute Care Hospital — 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
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.