UnitedHealthcare employer health plans in Wisconsin
Who UnitedHealthcare insures among Wisconsin 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 Wisconsin at a glance
What the data shows
UnitedHealthcare insures 234 employer health plans in Wisconsin (31% of 743 insured large plans), 2nd of 8 carrier groups; regional insurers hold more.
UnitedHealthcare has grown 35% in Wisconsin since 2020, from 173 plans.
Most of these plans cover 100–499 people (153 plans); 12 cover 1,000 or more.
Median premium per person covered was $6,123, 7% below the Wisconsin all-carrier median of $6,598. Benefit design and group mix differ, so this is not a price comparison.
86% of these plans reported broker or agent pay on their UnitedHealthcare contracts; where paid, the median was 3.1% of premium (middle half 2.0%–4.3%).
In UnitedHealthcare Choice, 34 of the 50 Employer 50 services have a Wisconsin benchmark, at a median of 251% of Medicare across those services.
At Wisconsin hospitals, UnitedHealthcare's commercial rates run higher than other carriers' at the same hospital for 4 of 17 services; a hip or knee replacement stay has a median rate of $26,116 across 29 hospitals.
UnitedHealthcare plans in Wisconsin, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 173 | 70,050 | 22% | $5,412 |
| 2021 | 187 | 81,433 | 24% | $5,496 |
| 2022 | 203 | 96,014 | 25% | $5,357 |
| 2023 | 236 | 91,779 | 29% | $6,095 |
| 2024 | 234 | 87,070 | 31% | $6,123 |
| 2025 (partial) | 164 | 56,117 | 29% | $6,723 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 33 | 14% |
| 100–499 | 153 | 65% |
| 500–999 | 35 | 15% |
| 1,000–4,999 | 12 | 5% |
| 5,000 or more | 0 | 0% |
Premiums and broker pay
| Measure | UnitedHealthcare | All carriers, Wisconsin |
|---|---|---|
| Median premium per person covered | $6,123 | $6,598 |
| Premium per person, middle half | $4,392–$7,890 | $4,949–$8,656 |
| Plans reporting broker or agent pay | 86% | 81% |
| Median broker pay, % of premium | 3.1% | 2.5% |
| Broker pay, middle half | 2.0%–4.3% | 1.7%–3.9% |
| Median broker pay per person covered | $178 | $160 |
Industries
UnitedHealthcare's Wisconsin employer clients are concentrated in manufacturing (82 plans) and health care and social assistance (26), followed by professional and technical services (15).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 82 | 35% |
| Health care and social assistance | 26 | 11% |
| Professional and technical services | 15 | 6% |
| Construction | 15 | 6% |
| Retail trade | 13 | 6% |
| Wholesale trade | 12 | 5% |
UnitedHealthcare employer clients in Wisconsin
226 employers in Wisconsin have a UnitedHealthcare major-medical contract, 12 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 Wisconsin →
What the UnitedHealthcare network pays physicians in Wisconsin
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $636 | $392–$853 | 221% | $502 | 13 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $181 | $112–$322 | 268% | $120 | 65 |
| Electrocardiogram (EKG), complete | 93000 | $38 | $26–$58 | 244% | $26 | 47 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $190 | $109–$303 | 255% | $119 | 66 |
| Treadmill stress test, complete | 93015 | $172 | $116–$292 | 233% | $132 | 47 |
| Skin biopsy, single lesion (tangential) | 11102 | $218 | $139–$397 | 228% | – | 50 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45385 | $1,183 | $661–$1,616 | 530% | – | 19 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43235 | $460 | $237–$527 | 416% | – | 21 |
| Cataract removal with lens implant | 66984 | $1,047 | $832–$2,202 | 226% | $940 | 57 |
| Abdominal ultrasound, complete | 76700 | $97 | $55–$159 | 258% | $56 | 89 |
| Bone density scan (DXA), axial | 77080 | $26 | $13–$40 | 281% | $14 | 89 |
| CT abdomen and pelvis with contrast | 74177 | $240 | $123–$354 | 286% | $134 | 89 |
| CT chest without contrast | 71250 | $149 | $77–$214 | 301% | $78 | 89 |
| Chest X-ray, 2 views | 71046 | $25 | $15–$42 | 253% | $15 | 89 |
| MRI brain without and with contrast | 70553 | $287 | $168–$410 | 273% | $171 | 80 |
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 Wisconsin
UnitedHealthcare commercial rates are on record at 58 Wisconsin 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 4 of 17 services and lower for 11. For Emergency visit, level 4, the rate runs from $109 to $2,776 across 31 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) | 29 | $26,116 | $15,986–$57,216 | Lower | – |
| C-section delivery (hospital stay) | 40 | Locked | Locked | About the same | Locked |
| Vaginal delivery (hospital stay) | 40 | Locked | Locked | Higher | Locked |
| MRI, lower back | 26 | $773 | $84–$1,732 | Lower | $2,110 |
| MRI, knee | 27 | Locked | Locked | Lower | Locked |
| CT, head | 28 | Locked | Locked | Lower | Locked |
| CT, abdomen and pelvis | 28 | Locked | Locked | Lower | Locked |
| Screening mammogram | 24 | Locked | Locked | About the same | Locked |
| Colonoscopy, diagnostic | 25 | Locked | Locked | Lower | Locked |
| Upper GI endoscopy with biopsy | 25 | Locked | Locked | Lower | Locked |
| Knee arthroscopy | 24 | Locked | Locked | Higher | Locked |
| Cataract surgery | 26 | Locked | Locked | Lower | Locked |
| Gallbladder removal, laparoscopic | 26 | Locked | Locked | Higher | Locked |
| Knee replacement, outpatient | 25 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 31 | $2,000 | $109–$2,776 | Lower | $525 |
| Comprehensive metabolic panel | 30 | Locked | Locked | Lower | Locked |
| Complete blood count | 30 | 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 |
|---|---|---|---|---|---|---|
| Aurora Baycare Medical Center | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Lakeland Medical Center | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Bay Area | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Burlington | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Grafton | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Kenosha | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Manitowoc County | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Oshkosh | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Aurora Medical Center Summit | $26,116 | Locked | Locked | Locked | Locked | Locked |
| Froedtert Hospital | $47,783 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 32%, fee schedules 18%, per diem 0%, percent of billed charges 15%, other 35% of UnitedHealthcare's published commercial rates for these services in Wisconsin.
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 Wisconsin
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Other insurers (regional and local plans) | 368 | 50% | $6,823 | 2.1% |
| UnitedHealthcare | 234 | 31% | $6,123 | 3.1% |
| Blue Cross Blue Shield | 131 | 18% | $6,698 | 3.0% |
| Anthem (Elevance Health) | 69 | 9% | $7,802 | 2.5% |
| Kaiser Permanente | 34 | 5% | $7,767 | 3.7% |
| Cigna | 24 | 3% | $6,510 | 7.3% |
| Aetna | 10 | 1% | $3,144 | 5.7% |
| Humana | 6 | 1% | $2,383 | 4.2% |
UnitedHealthcare in other states
FAQ
How many Wisconsin employers have UnitedHealthcare health insurance?
234 employer health plans in Wisconsin reported a UnitedHealthcare major-medical contract in their 2024 filings, covering 87,070 persons. Self-funded plans that UnitedHealthcare only administers are not counted.
What is UnitedHealthcare's share of the Wisconsin insured employer market?
31% of insured large employer health plans, 2nd of 8 carrier groups by plan count.
How much do brokers earn on UnitedHealthcare plans in Wisconsin?
Where broker or agent pay was reported, the median was 3.1% of premium (2.5% across all carriers in Wisconsin).
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 234 Wisconsin 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: 222 contracts with 20+ persons covered and a reported premium; broker percentages use the 201 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 Wisconsin hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.