Payers shown: Highmark Blue Cross Blue Shield (Pennsylvania, Delaware, West Virginia, New York)
Prices shown: surgery centers and hospital outpatient departments
Doctor’s fee or facility fee?This mixes two kinds of price: 25% are doctors' fees and 75% 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.
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 a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01) — the price for a doctor's own office. 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. The prices on this map include a facility fee, which Medicare pays separately and which is not in its physician price, so the ratio here runs high and is a rough guide only.
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.