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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© 2021 MMIT

Jinghong Chen Reporter

Jinghong produces infographics and data stories on health insurance and specialty pharmacy for AIS Health. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting. Before joining AIS in 2018, she worked at WBEZ, Al Jazeera English and The New York Times Chinese.

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