Doctor’s fee or facility fee? This is the hospital's own payment for the stay (the facility fee). Surgeons, anesthesiologists and other doctors bill separately, on top of it.
Who is counted: EmblemHealth lists clinicians individually: 98% of the 161,225 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs.
Not in these files: Maternity care is often contracted as a case rate or a bundle outside the fee schedule — under a per-case or AP-DRG code set this site does not read (it reads CPT, HCPCS and MS-DRG). A hospital system paid that way is missing here, and such systems can be among the most expensive in a market.
Not on this map: Care in New Jersey: for some plans, EmblemHealth rents the QualCare network. Its prices are QualCare's, so they are not included here. Montefiore's doctors and hospitals are missing: the Montefiore file EmblemHealth publishes dates from 2022, is not in the required format, and points to a provider list that is no longer there. These are EmblemHealth's August 2026 files - the newest it had published when this was built. Doctors EmblemHealth pays a flat monthly amount per patient (capitation) have no price per visit. For them its files carry a placeholder of ten cents, marked as a derived amount; those entries are left out, so such doctors may not appear on a map.
State
Providers
Organisations
Zip codes
Lowest
25th pct
Median
75th pct
Highest
vs Medicare
“x Medicare” compares each price with what original Medicare actually paid hospitals in the same state for the same kind of stay in 2024, the newest year it has published: the average per stay, the patient’s share included, at hospitals with more than ten such stays. Medicare’s payment varies by hospital (wages, teaching, low-income patients), so this is a state average, not any one hospital’s rate. 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.