UnitedHealthcare · payer overview
UnitedHealthcare negotiated rates by state and specialty
Where UnitedHealthcare pays above and below the market, from its published in-network files.
UnitedHealthcare at a glance
228 codes · 51 states · 31,635 sampled providers · source: UnitedHealthcare Choice plans
Rate index
113
100 = four-payer median
Payer rank
1 of 4
1 = highest
Median % of Medicare
167%
across tracked codes
Highest on
69%
of codes
What the data shows
1
UnitedHealthcare ranks 1st of 4 payers with a rate index of 113 (100 = four-payer median) across 228 procedure codes.
2
Its median rate is 167% of Medicare, and it has the highest median on 69% of codes in the files analyzed.
3
Strongest market: District of Columbia (index 142 vs that state's market); weakest: Mississippi (90).
4
Largest premium over the market: CPT 64566 (Neuroeltrd stim post tibial) at 215% of market.
5
By specialty it is strongest for gastroenterology (ranks 1st of 4 payers).
UnitedHealthcare by state
Index vs the state market; own-national index vs the payer's national level
| State | Index vs market | Rank in state | vs own national | Level | Providers |
|---|---|---|---|---|---|
| District of Columbia | 142 | 1 of 4 | 132 | 396 | |
| Vermont | 142 | 1 of 4 | 126 | 279 | |
| Minnesota | 141 | 1 of 4 | 166 | 618 | |
| New Hampshire | 139 | 1 of 4 | 144 | 629 | |
| Massachusetts | 137 | 1 of 4 | 152 | 772 | |
| Illinois | 133 | 1 of 4 | 111 | 706 | |
| New Mexico | 132 | 1 of 4 | 109 | 471 | |
| Maryland | 131 | 1 of 4 | 95 | 606 | |
| West Virginia | 130 | 1 of 4 | 103 | 512 | |
| Rhode Island | 129 | 1 of 4 | 104 | 468 | |
| New York | 128 | 1 of 4 | 101 | 801 | |
| Connecticut | 127 | 1 of 4 | 135 | 804 | |
| California | 126 | 1 of 4 | 96 | 658 | |
| Wisconsin | 125 | 1 of 4 | 173 | 610 | |
| Texas | 124 | 1 of 4 | 88 | 824 | |
| Maine | 124 | 1 of 4 | 114 | 546 | |
| Oregon | 121 | 1 of 4 | 164 | 683 | |
| Oklahoma | 120 | 1 of 4 | 84 | 728 | |
| Iowa | 118 | 1 of 4 | 132 | 605 | |
| Indiana | 117 | 1 of 4 | 89 | 805 | |
| Nebraska | 116 | 1 of 4 | 139 | 556 | |
| Virginia | 116 | 1 of 4 | 93 | 733 | |
| Georgia | 115 | 1 of 4 | 125 | 780 | |
| Arizona | 115 | 1 of 4 | 82 | 699 | |
| Pennsylvania | 115 | 1 of 4 | 96 | 751 | |
| Ohio | 115 | 1 of 4 | 98 | 802 | |
| Kentucky | 114 | 1 of 4 | 88 | 820 | |
| Montana | 114 | 2 of 4 | 100 | 323 | |
| Alaska | 114 | 2 of 4 | 193 | 164 | |
| Colorado | 113 | 1 of 4 | 105 | 749 | |
| Missouri | 112 | 1 of 4 | 93 | 821 | |
| Florida | 112 | 1 of 4 | 78 | 744 | |
| Tennessee | 112 | 1 of 4 | 96 | 775 | |
| South Carolina | 111 | 2 of 4 | 89 | 733 | |
| Arkansas | 111 | 1 of 4 | 91 | 680 | |
| North Carolina | 111 | 1 of 4 | 112 | 747 | |
| Utah | 111 | 1 of 4 | 95 | 649 | |
| Nevada | 110 | 1 of 4 | 84 | 629 | |
| New Jersey | 109 | 1 of 4 | 97 | 724 | |
| Delaware | 108 | 1 of 4 | 83 | 379 | |
| Washington | 106 | 1 of 4 | 128 | 695 | |
| Louisiana | 106 | 1 of 4 | 83 | 808 | |
| Michigan | 106 | 2 of 4 | 84 | 664 | |
| South Dakota | 104 | 1 of 4 | 122 | 316 | |
| North Dakota | 102 | 2 of 4 | 120 | 210 | |
| Kansas | 102 | 1 of 4 | 88 | 640 | |
| Hawaii | 100 | 2 of 4 | 88 | 453 | |
| Idaho | 98 | 3 of 4 | 98 | 546 | |
| Alabama | 96 | 3 of 4 | 73 | 719 | |
| Wyoming | 93 | 2 of 4 | 110 | 129 | |
| Mississippi | 90 | 3 of 4 | 86 | 676 |
UnitedHealthcare by specialty
Index vs the four-payer median for the specialty's codes
| Specialty | Index | Rank of 4 | Highest on | Providers |
|---|---|---|---|---|
| Gastroenterology | 116 | 1 of 4 | 89% | 3,767 |
| Internal medicine | 119 | 1 of 4 | 88% | 4,253 |
| Urology | 121 | 1 of 4 | 81% | 3,590 |
| Orthopedic surgery | 110 | 1 of 4 | 67% | 4,265 |
| Dermatology | 119 | 1 of 4 | 84% | 3,646 |
| Cardiology | 114 | 1 of 4 | 82% | 4,303 |
| Ophthalmology | 107 | 1 of 4 | 55% | 3,838 |
| Diagnostic radiology | 114 | 1 of 4 | 63% | 3,973 |
Where UnitedHealthcare pays most and least against the market
Highest above market
| Code | UHC | vs market |
|---|---|---|
| 64566 Neuroeltrd stim post tibial | $149 | +115% |
| 52224 Cystoscopy and treatment | $966 | +111% |
| 52332 Cystoscopy and treatment | $691 | +92% |
| 52648 Laser surgery of prostate | $2,820 | +87% |
| 11104 Punch bx skin single lesion | $149 | +84% |
| 11102 Tangntl bx skin single les | $119 | +83% |
| 43255 Egd control bleeding any | $822 | +79% |
| 43251 Egd remove lesion snare | $756 | +78% |
Furthest below market
| Code | UHC | vs market |
|---|---|---|
| 92235 Fluorescein angrph mltiframe | $128 | -12% |
| 88342 Imhchem/imcytchm 1st antb | $86 | -10% |
| 76512 Oph us dx b-scan | $65 | -8% |
| 93297 Rem interrog dev eval icpms | $48 | -8% |
| 88312 Special stains group 1 | $91 | -6% |
| 93298 Rem interrog dev eval scrms | $49 | -6% |
| 88305 Tissue exam by pathologist | $67 | -5% |
| 88313 Special stains group 2 | $67 | -5% |
Methodology
How these numbers are calculated
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your UnitedHealthcare contract at market?
Compare your negotiated rates with these medians by state and specialty.