Doctor’s fee or facility fee? These are single prices the insurer publishes for both the doctor's and the facility's part of the service. 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: Medica lists clinicians individually: 99% of the 60,993 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 Medica's own network: for many plans Medica rents UnitedHealthcare's national networks (Choice Plus and Options PPO), and for some MultiPlan (PHCS), Midlands Choice and Healthcare Highways. Those prices are set by those networks, so they are not included here. Mental health care: Medica rents Optum's behavioral health network; its prices are not included here.
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.