Commercial Fees for Clinician-Delivered Services Averaged 122% of Medicare Rates in 2017

The amount that private insurers paid for professional health care services (i.e. those delivered by a clinician) were, on average, 122% of Medicare rates nationally in 2017, according to a recent Health Care Cost Institute report. In seven states, the average commercial prices exceeded 150% of Medicare rates, while eleven states saw average clinician fees within 10% of Medicare. Though no state reported payments higher than 200% of Medicare rates, five metro areas in Wisconsin had prices above this threshold. Places with higher commercial prices tended to be in the Northwest, and in the areas around large cities.

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© 2024 MMIT
Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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