UnitedHealthcare negotiated rates in Georgia
How UnitedHealthcare's Georgia rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in Georgia at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Georgia with a rate index of 115 (100 = the Georgia market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 61% of codes in Georgia.
UnitedHealthcare's Georgia rates sit 25% above its own national level, the 13th highest of its 51 states.
Largest premium over the Georgia market: CPT 11104 (Punch bx skin single lesion) at 243% of market; largest discount: CPT 45390 (Colonoscopy w/resection) at 73%.
How the four payers compare in Georgia
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 61% | 780 | |
| Cigna | 105 | 2 | 27% | 829 | |
| Blue Cross Blue Shield | 98 | 3 | 10% | 944 | |
| Aetna | 83 | 4 | 2% | 755 |
Where UnitedHealthcare pays most and least against the Georgia market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 11104 Punch bx skin single lesion | $231 | $95 | +143% | 105 |
| 11102 Tangntl bx skin single les | $177 | $76 | +131% | 105 |
| 11301 Shave skin lesion 0.6-1.0 cm | $224 | $108 | +109% | 105 |
| 11302 Shave skin lesion 1.1-2.0 cm | $260 | $135 | +92% | 105 |
| 17313 Mohs 1 stage t/a/l | $1,154 | $654 | +76% | 105 |
| 92012 Intrm oph exam est patient | $163 | $94 | +72% | 98 |
| 52332 Cystoscopy and treatment | $766 | $447 | +71% | 104 |
| 17311 Mohs 1 stage h/n/hf/g | $1,231 | $719 | +71% | 105 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 45390 Colonoscopy w/resection | $519 | $711 | -27% | 104 |
| 43264 Ercp remove duct calculi | $586 | $787 | -26% | 104 |
| 43237 Endoscopic us exam esoph | $315 | $423 | -26% | 104 |
| 43238 Egd us fine needle bx/aspir | $374 | $503 | -26% | 104 |
| 43259 Egd us exam duodenum/jejunum | $365 | $489 | -25% | 104 |
| 43246 Egd place gastrostomy tube | $324 | $433 | -25% | 104 |
| 43274 Ercp duct stent placement | $724 | $963 | -25% | 104 |
| 43276 Ercp stent exchange w/dilate | $753 | $999 | -25% | 104 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in Georgia?
UnitedHealthcare ranks 1st of 4 in Georgia with an index of 115. It is highest on 61% of codes.
Are UnitedHealthcare's Georgia rates above or below its national level?
About 25% above.
Which procedure does UnitedHealthcare pay most above market in Georgia?
CPT 11104 (Punch bx skin single lesion), at 243% of the Georgia 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 Georgia?
Compare your negotiated rates for these codes with Georgia medians for each payer.