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. 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: Blue Shield of California lists clinicians individually: 81% of the 118,936 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: These prices come from the file set every Blue plan publishes centrally for members of other Blue plans (BlueCard). It may leave out networks the plan publishes only on its own site.
State
Providers
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
Doctor’s fee
Facility fee
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.