UnitedHealthcare · Illinois · commercial in-network

UnitedHealthcare negotiated rates in Illinois

How UnitedHealthcare's Illinois rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.

UnitedHealthcare in Illinois at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
133
33% above the Illinois median
Rank in state
1 of 4
UHC 133 · Cigna 106 · Aetna 88 · BCBS 86
vs own national
111
UHC's level vs its national median
Codes where highest
86%
of 228 codes
706 sampled providers512 TINs228 codesMedian 188% of Medicare · method

What the data shows

Generated from Illinois and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in Illinois with a rate index of 133 (100 = the Illinois market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for 86% of codes in Illinois.

3

UnitedHealthcare's Illinois rates sit 11% above its own national level, the 18th highest of its 51 states.

4

Largest premium over the Illinois market: CPT 52224 (Cystoscopy and treatment) at 321% of market; largest discount: CPT 51798 (Us urine capacity measure) at 85%.

How the four payers compare in Illinois

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1331
133
86%706
Cigna1062
106
8%644
Aetna883
88
1%626
Blue Cross Blue Shield864
86
5%841

Where UnitedHealthcare pays most and least against the Illinois market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
52224
Cystoscopy and treatment
$1,345$419+221%87
52332
Cystoscopy and treatment
$852$322+165%88
64566
Neuroeltrd stim post tibial
$152$58+161%88
43255
Egd control bleeding any
$1,006$390+158%91
52648
Laser surgery of prostate
$3,154$1,237+155%88
51700
Irrigation of bladder
$143$60+137%87
52000
Cystourethroscopy
$395$169+134%88
11102
Tangntl bx skin single les
$144$62+131%95

Furthest below market

CodeUHCMarketGapProv.
51798
Us urine capacity measure
$19$23-15%88
65820
Goniotomy
$999$1,164-14%91
66991
Xcapsl ctrc rmvl insj 1+
$868$997-13%90
66821
After cataract laser surgery
$404$463-13%91
65756
Corneal trnspl endothelial
$1,438$1,634-12%90
67036
Removal of inner eye fluid
$1,157$1,296-11%91
96574
Dbrdmt prmlg les w/pdt
$348$364-5%95
66984
Xcapsl ctrc rmvl w/o ecp
$852$892-4%91

Where UnitedHealthcare pays above and below its national level

Index vs the payer's own national median (100 = national)

Highest states

StateIndexProv.
Alaska193
164
Wisconsin173
610
Minnesota166
618
Oregon164
683
Massachusetts152
772

Lowest states

StateIndexProv.
Alabama73
719
Florida78
744
Arizona82
699
Louisiana83
808
Delaware83
379

Frequently asked questions

Does UnitedHealthcare pay more or less than the other payers in Illinois?

UnitedHealthcare ranks 1st of 4 in Illinois with an index of 133. It is highest on 86% of codes.

Are UnitedHealthcare's Illinois rates above or below its national level?

About 11% above.

Which procedure does UnitedHealthcare pay most above market in Illinois?

CPT 52224 (Cystoscopy and treatment), at 321% of the Illinois median.

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.

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