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
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Illinois with a rate index of 133 (100 = the Illinois market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 86% of codes in Illinois.
UnitedHealthcare's Illinois rates sit 11% above its own national level, the 18th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 133 | 1 | 86% | 706 | |
| Cigna | 106 | 2 | 8% | 644 | |
| Aetna | 88 | 3 | 1% | 626 | |
| Blue Cross Blue Shield | 86 | 4 | 5% | 841 |
Where UnitedHealthcare pays most and least against the Illinois market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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
- 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 Illinois?
Compare your negotiated rates for these codes with Illinois medians for each payer.