Payers shown: Highmark Blue Cross Blue Shield (Pennsylvania, Delaware, West Virginia, New York)
Prices shown: every in-person setting
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. (About 3% of these prices are doctors' fees instead, which can show up as unusually low prices.)
Who is counted: Highmark Blue Cross Blue Shield lists clinicians individually: 98% of the 118,859 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
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 Highmark Blue Cross Blue Shield, so they are not included here.
State
Providers
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
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.