UnitedHealthcare employer health plans in North Carolina
Who UnitedHealthcare insures among North Carolina employers and what those plans pay in premium and broker compensation, and what the UnitedHealthcare network pays physicians and hospitals.
UnitedHealthcare employer health plans in North Carolina at a glance
What the data shows
UnitedHealthcare insures 153 employer health plans in North Carolina (16% of 939 insured large plans), 3rd of 8 carrier groups; Blue Cross Blue Shield (478), Cigna (186) hold more.
UnitedHealthcare has shrunk 10% in North Carolina since 2020, from 170 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (78 plans); 8 cover 1,000 or more.
Median premium per person covered was $6,004, 0% below the North Carolina all-carrier median of $6,006. Benefit design and group mix differ, so this is not a price comparison.
85% of these plans reported broker or agent pay on their UnitedHealthcare contracts; where paid, the median was 4.8% of premium (middle half 3.4%–6.4%).
In UnitedHealthcare Choice, 34 of the 50 Employer 50 services have a North Carolina benchmark, at a median of 178% of Medicare across those services.
At North Carolina hospitals, UnitedHealthcare's commercial rates run higher than other carriers' at the same hospital for 10 of 14 services; a hip or knee replacement stay has a median rate of $48,249 across 15 hospitals.
UnitedHealthcare plans in North Carolina, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 170 | 68,756 | 18% | $5,010 |
| 2021 | 164 | 80,265 | 17% | $4,731 |
| 2022 | 194 | 86,091 | 18% | $5,217 |
| 2023 | 174 | 78,355 | 18% | $5,718 |
| 2024 | 153 | 77,950 | 16% | $6,004 |
| 2025 (partial) | 88 | 71,419 | 16% | $5,350 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 49 | 32% |
| 100–499 | 78 | 51% |
| 500–999 | 18 | 12% |
| 1,000–4,999 | 5 | 3% |
| 5,000 or more | 3 | 2% |
Premiums and broker pay
| Measure | UnitedHealthcare | All carriers, North Carolina |
|---|---|---|
| Median premium per person covered | $6,004 | $6,006 |
| Premium per person, middle half | $3,785–$7,408 | $3,259–$8,027 |
| Plans reporting broker or agent pay | 85% | 79% |
| Median broker pay, % of premium | 4.8% | 4.0% |
| Broker pay, middle half | 3.4%–6.4% | 2.6%–6.3% |
| Median broker pay per person covered | $255 | $216 |
Industries
UnitedHealthcare's North Carolina employer clients are concentrated in manufacturing (41 plans) and professional and technical services (19), followed by construction (14).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 41 | 27% |
| Professional and technical services | 19 | 12% |
| Construction | 14 | 9% |
| Retail trade | 14 | 9% |
| Health care and social assistance | 13 | 8% |
| Finance and insurance | 9 | 6% |
UnitedHealthcare employer clients in North Carolina
148 employers in North Carolina have a UnitedHealthcare major-medical contract, 8 of them covering 1,000 or more people. For each one Medlyze has the plan year, the broker on each contract and what that broker was paid, and compiles the list for a state, an industry or a single employer on request.
| Employer | Persons covered | Plan year ends | Broker | Broker pay, % of premium |
|---|---|---|---|---|
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
Brokers: request the UnitedHealthcare Prospect List for North Carolina →
What the UnitedHealthcare network pays physicians in North Carolina
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $515 | $463–$1,096 | 179% | $507 | 17 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $124 | $95–$188 | 183% | $108 | 68 |
| Electrocardiogram (EKG), complete | 93000 | $31 | $25–$41 | 204% | $24 | 59 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $143 | $95–$191 | 192% | $121 | 68 |
| Treadmill stress test, complete | 93015 | $128 | $104–$188 | 174% | $110 | 38 |
| Skin biopsy, single lesion (tangential) | 11102 | $96 | $90–$131 | 101% | $114 | 65 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45378 | $492 | $267–$802 | 299% | $619 | 21 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43235 | $198 | $166–$349 | 180% | $400 | 24 |
| Cataract removal with lens implant | 66984 | $718 | $585–$823 | 155% | $622 | 52 |
| Abdominal ultrasound, complete | 76700 | $207 | $143–$278 | 182% | $168 | 103 |
| Bone density scan (DXA), axial | 77080 | $75 | $51–$101 | 190% | $84 | 103 |
| CT abdomen and pelvis with contrast | 74177 | $572 | $384–$728 | 190% | $489 | 103 |
| CT chest without contrast | 71250 | $295 | $191–$378 | 223% | $297 | 103 |
| Chest X-ray, 2 views | 71046 | $57 | $37–$69 | 172% | $45 | 103 |
| MRI brain without and with contrast | 70553 | $704 | $443–$994 | 222% | $770 | 103 |
Professional fee only: facility, implant and anesthesia charges are not included. Limited: rates come from a sample of providers, and groups are counted only in specialties that perform the service.
What the UnitedHealthcare network pays hospitals in North Carolina
UnitedHealthcare commercial rates are on record at 39 North Carolina hospitals (the hospitals covered so far, not every hospital). Compared at the same hospitals, UnitedHealthcare's rate is higher than the other carriers' median for 10 of 14 services and lower for 1. For MRI, lower back, the rate runs from $290 to $3,318 across 17 hospitals.
This page shows 3 of the 14 services in full. The other rates, the size of each gap and every hospital's prices are in the Plan Cost Benchmark.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 15 | $48,249 | $15,909–$51,634 | Higher | – |
| C-section delivery (hospital stay) | 15 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 13 | Locked | Locked | Higher | Locked |
| MRI, lower back | 17 | $290 | $290–$3,318 | Higher | $2,013 |
| MRI, knee | 17 | Locked | Locked | Higher | Locked |
| CT, head | 14 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 14 | Locked | Locked | Higher | Locked |
| Screening mammogram | 14 | Locked | Locked | About the same | Locked |
| Colonoscopy, diagnostic | 12 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 12 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 11 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 22 | $1,254 | $229–$2,372 | About the same | $1,591 |
| Comprehensive metabolic panel | 23 | Locked | Locked | About the same | Locked |
| Complete blood count | 23 | Locked | Locked | Lower | Locked |
Hospitals with the most published UnitedHealthcare rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Atrium Health Anson | – | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Cabarrus | – | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Carolinas Medical Center | – | Locked | Locked | Locked | Locked | Locked |
| Mission Hospital | $15,909 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Ballantyne Medical Center | $49,743 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Matthews Medical Center | $49,815 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Mint Hill Medical Center | $49,815 | Locked | Locked | Locked | Locked | Locked |
| Novant Health New Hanover Regional Medical Center | $45,240 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Presbyterian Medical Center | $49,815 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Rowan Medical Center | $48,249 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 6%, fee schedules 14%, per diem 31%, percent of billed charges 29%, other 19% of UnitedHealthcare's published commercial rates for these services in North Carolina.
Employers: see all 14 services and every hospital near your people in a Plan Cost Benchmark →
Hospital facility rate only: physician, anesthesia and implant charges are separate. Rates are what hospitals publish, not claims paid, and are not weighted by use.
Carriers in North Carolina
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 478 | 51% | $6,672 | 3.2% |
| Cigna | 186 | 20% | $2,375 | 8.1% |
| UnitedHealthcare | 153 | 16% | $6,004 | 4.8% |
| Other insurers (regional and local plans) | 89 | 9% | $1,360 | 9.6% |
| Aetna | 66 | 7% | $5,745 | 1.5% |
| Kaiser Permanente | 64 | 7% | $8,943 | 2.9% |
| Anthem (Elevance Health) | 8 | 1% | $6,519 | 5.0% |
| Humana | 3 | 0% | $3,482 | 2.7% |
UnitedHealthcare in other states
FAQ
How many North Carolina employers have UnitedHealthcare health insurance?
153 employer health plans in North Carolina reported a UnitedHealthcare major-medical contract in their 2024 filings, covering 77,950 persons. Self-funded plans that UnitedHealthcare only administers are not counted.
What is UnitedHealthcare's share of the North Carolina insured employer market?
16% of insured large employer health plans, 3rd of 8 carrier groups by plan count.
How much do brokers earn on UnitedHealthcare plans in North Carolina?
Where broker or agent pay was reported, the median was 4.8% of premium (4.0% across all carriers in North Carolina).
Can I see the figures for a specific employer?
Yes. Brokers can request an Employer Account Brief on one employer, or a Prospect List for this market. Employers can request a Plan Cost Benchmark for their own plan. Use the request form on this page.
About these numbers
- Plans counted: the 153 North Carolina employer health plans with a UnitedHealthcare major-medical contract in their 2024 filings. Self-funded plans that UnitedHealthcare only administers are not counted here.
- Premium and broker figures: 131 contracts with 20+ persons covered and a reported premium; broker percentages use the 130 contracts that reported broker or agent pay.
- Network rates: UnitedHealthcare Choice, professional fees only, from a sample of providers.
- Hospital prices: UnitedHealthcare commercial rates at North Carolina hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.