UnitedHealthcare negotiated rates in District of Columbia
How UnitedHealthcare's District of Columbia rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in District of Columbia at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in District of Columbia with a rate index of 142 (100 = the District of Columbia market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 59% of codes in District of Columbia.
UnitedHealthcare's District of Columbia rates sit 32% above its own national level, the 10th highest of its 51 states.
Largest premium over the District of Columbia market: CPT 93298 (Rem interrog dev eval scrms) at 538% of market; largest discount: CPT 92235 (Fluorescein angrph mltiframe) at 71%.
How the four payers compare in District of Columbia
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 142 | 1 | 59% | 396 | |
| Cigna | 121 | 2 | 19% | 430 | |
| Aetna | 102 | 3 | 21% | 357 | |
| Blue Cross Blue Shield | 66 | 4 | 1% | 484 |
Where UnitedHealthcare pays most and least against the District of Columbia market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $316 | $59 | +438% | 67 |
| 93297 Rem interrog dev eval icpms | $185 | $60 | +206% | 67 |
| 52332 Cystoscopy and treatment | $1,095 | $396 | +176% | 38 |
| 36482 Endoven ther chem adhes 1st | $546 | $218 | +150% | 66 |
| 77049 Mri breast c-+ w/cad bi | $1,202 | $500 | +140% | 82 |
| 43239 Egd biopsy single/multiple | $908 | $381 | +138% | 43 |
| 70496 Ct angiography head | $1,050 | $441 | +138% | 82 |
| 43235 Egd diagnostic brush wash | $684 | $292 | +134% | 43 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 92235 Fluorescein angrph mltiframe | $103 | $145 | -29% | 46 |
| 76872 Us transrectal | $229 | $312 | -26% | 38 |
| 76775 Us exam abdo back wall lim | $102 | $135 | -25% | 38 |
| 76857 Us exam pelvic limited | $85 | $111 | -24% | 38 |
| 66984 Xcapsl ctrc rmvl w/o ecp | $569 | $687 | -17% | 46 |
| 67108 Repair detached retina | $1,197 | $1,421 | -16% | 46 |
| 67042 Vit for macular hole | $1,144 | $1,299 | -12% | 46 |
| 66982 Xcapsl ctrc rmvl cplx wo ecp | $792 | $886 | -11% | 46 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in District of Columbia?
UnitedHealthcare ranks 1st of 4 in District of Columbia with an index of 142. It is highest on 59% of codes.
Are UnitedHealthcare's District of Columbia rates above or below its national level?
About 32% above.
Which procedure does UnitedHealthcare pay most above market in District of Columbia?
CPT 93298 (Rem interrog dev eval scrms), at 538% of the District of Columbia median.
Methodology
- 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 in District of Columbia?
Compare your negotiated rates for these codes with District of Columbia medians for each payer.