UnitedHealthcare employer health plans in Pennsylvania
Who UnitedHealthcare insures among Pennsylvania 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 Pennsylvania at a glance
What the data shows
UnitedHealthcare insures 122 employer health plans in Pennsylvania (8% of 1,491 insured large plans), 5th of 8 carrier groups; Blue Cross Blue Shield (800), Cigna (207) hold more.
UnitedHealthcare has shrunk 27% in Pennsylvania since 2020, from 166 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (70 plans); 18 cover 1,000 or more.
Median premium per person covered was $5,192, 27% below the Pennsylvania all-carrier median of $7,075. Benefit design and group mix differ, so this is not a price comparison.
75% of these plans reported broker or agent pay on their UnitedHealthcare contracts; where paid, the median was 4.4% of premium (middle half 3.2%–6.0%).
In UnitedHealthcare Choice, 34 of the 50 Employer 50 services have a Pennsylvania benchmark, at a median of 157% of Medicare across those services.
At Pennsylvania hospitals, UnitedHealthcare's commercial rates run higher than other carriers' at the same hospital for 8 of 17 services; a hip or knee replacement stay has a median rate of $18,732 across 38 hospitals.
UnitedHealthcare plans in Pennsylvania, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 166 | 81,699 | 9% | $4,894 |
| 2021 | 153 | 114,212 | 9% | $4,733 |
| 2022 | 140 | 80,921 | 9% | $5,236 |
| 2023 | 137 | 98,950 | 8% | $5,587 |
| 2024 | 122 | 96,258 | 8% | $5,192 |
| 2025 (partial) | 73 | 62,960 | 8% | $5,085 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 16 | 13% |
| 100–499 | 70 | 57% |
| 500–999 | 17 | 14% |
| 1,000–4,999 | 15 | 12% |
| 5,000 or more | 3 | 2% |
Premiums and broker pay
| Measure | UnitedHealthcare | All carriers, Pennsylvania |
|---|---|---|
| Median premium per person covered | $5,192 | $7,075 |
| Premium per person, middle half | $3,206–$7,062 | $4,536–$9,457 |
| Plans reporting broker or agent pay | 75% | 69% |
| Median broker pay, % of premium | 4.4% | 3.7% |
| Broker pay, middle half | 3.2%–6.0% | 2.5%–5.3% |
| Median broker pay per person covered | $244 | $256 |
Industries
UnitedHealthcare's Pennsylvania employer clients are concentrated in manufacturing (22 plans) and professional and technical services (20), followed by wholesale trade (14).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 22 | 18% |
| Professional and technical services | 20 | 16% |
| Wholesale trade | 14 | 11% |
| Health care and social assistance | 12 | 10% |
| Finance and insurance | 10 | 8% |
| Construction | 9 | 7% |
UnitedHealthcare employer clients in Pennsylvania
117 employers in Pennsylvania have a UnitedHealthcare major-medical contract, 18 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 Pennsylvania →
What the UnitedHealthcare network pays physicians in Pennsylvania
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $480 | $413–$598 | 167% | $356 | 35 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $319 | $269–$398 | 162% | $278 | 79 |
| Electrocardiogram (EKG), complete | 93000 | $25 | $18–$32 | 161% | $25 | 54 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $625 | $465–$862 | 146% | $640 | 79 |
| Treadmill stress test, complete | 93015 | $129 | $102–$146 | 176% | $117 | 50 |
| Skin biopsy, single lesion (tangential) | 11102 | $100 | $92–$149 | 105% | $102 | 74 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45385 | $337 | $292–$405 | 151% | $575 | 25 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43235 | $191 | $167–$271 | 173% | $325 | 26 |
| Cataract removal with lens implant | 66984 | $621 | $540–$685 | 134% | $604 | 106 |
| Abdominal ultrasound, complete | 76700 | $189 | $143–$248 | 165% | $151 | 101 |
| Bone density scan (DXA), axial | 77080 | $67 | $49–$88 | 171% | $46 | 101 |
| CT abdomen and pelvis with contrast | 74177 | $500 | $366–$644 | 167% | $407 | 100 |
| CT chest without contrast | 71250 | $265 | $194–$332 | 199% | $226 | 102 |
| Chest X-ray, 2 views | 71046 | $49 | $34–$63 | 149% | $41 | 101 |
| MRI brain without and with contrast | 70553 | $637 | $451–$830 | 201% | $613 | 101 |
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 Pennsylvania
UnitedHealthcare commercial rates are on record at 56 Pennsylvania 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 8 of 17 services and lower for 7. For Emergency visit, level 4, the rate runs from $229 to $1,917 across 15 hospitals.
This page shows 3 of the 17 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) | 38 | $18,732 | $12,874–$40,785 | Lower | $34,462 |
| C-section delivery (hospital stay) | 37 | Locked | Locked | About the same | Locked |
| Vaginal delivery (hospital stay) | 37 | Locked | Locked | Lower | Locked |
| MRI, lower back | 22 | $380 | $221–$518 | Lower | $2,037 |
| MRI, knee | 22 | Locked | Locked | Lower | Locked |
| CT, head | 22 | Locked | Locked | Lower | Locked |
| CT, abdomen and pelvis | 22 | Locked | Locked | About the same | Locked |
| Screening mammogram | 20 | Locked | Locked | Lower | Locked |
| Colonoscopy, diagnostic | 13 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 13 | Locked | Locked | Higher | Locked |
| Knee arthroscopy | 13 | Locked | Locked | Higher | Locked |
| Cataract surgery | 13 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 15 | Locked | Locked | Higher | Locked |
| Knee replacement, outpatient | 16 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 15 | $229 | $229–$1,917 | Higher | $1,794 |
| Comprehensive metabolic panel | 21 | Locked | Locked | Higher | Locked |
| Complete blood count | 21 | 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 |
|---|---|---|---|---|---|---|
| Ahn Allegheny General Hospital | $13,719 | Locked | Locked | Locked | Locked | Locked |
| Ahn Allegheny Valley Hospital | $12,865 | Locked | Locked | Locked | Locked | Locked |
| Ahn Canonsburg General Hospital | $12,874 | Locked | Locked | Locked | Locked | Locked |
| Ahn Forbes Hospital | $13,363 | Locked | Locked | Locked | Locked | Locked |
| Ahn Grove City Medical Center | $15,707 | Locked | Locked | Locked | Locked | Locked |
| Ahn Saint Vincent Hospital | $15,305 | Locked | Locked | Locked | Locked | Locked |
| Ahn Wexford Hospital | $13,195 | Locked | Locked | Locked | Locked | Locked |
| Holy Redeemer Hospital | $23,740 | Locked | Locked | Locked | Locked | Locked |
| Jefferson Lansdale Hospital | $13,389 | Locked | Locked | Locked | Locked | Locked |
| Jefferson Torresdale Hospital | $16,258 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 9%, fee schedules 82%, per diem 0%, percent of billed charges 2%, other 7% of UnitedHealthcare's published commercial rates for these services in Pennsylvania.
Employers: see all 17 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 Pennsylvania
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 800 | 54% | $7,441 | 3.3% |
| Other insurers (regional and local plans) | 423 | 28% | $7,243 | 3.4% |
| Cigna | 207 | 14% | $3,936 | 6.1% |
| Aetna | 158 | 11% | $5,612 | 3.1% |
| UnitedHealthcare | 122 | 8% | $5,192 | 4.4% |
| Kaiser Permanente | 97 | 7% | $9,455 | 3.0% |
| Anthem (Elevance Health) | 7 | 0% | $8,992 | 2.0% |
| Humana | 5 | 0% | $2,657 | – |
UnitedHealthcare in other states
FAQ
How many Pennsylvania employers have UnitedHealthcare health insurance?
122 employer health plans in Pennsylvania reported a UnitedHealthcare major-medical contract in their 2024 filings, covering 96,258 persons. Self-funded plans that UnitedHealthcare only administers are not counted.
What is UnitedHealthcare's share of the Pennsylvania insured employer market?
8% of insured large employer health plans, 5th of 8 carrier groups by plan count.
How much do brokers earn on UnitedHealthcare plans in Pennsylvania?
Where broker or agent pay was reported, the median was 4.4% of premium (3.7% across all carriers in Pennsylvania).
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 122 Pennsylvania 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: 114 contracts with 20+ persons covered and a reported premium; broker percentages use the 90 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 Pennsylvania hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.