UnitedHealthcare · New Jersey · commercial in-network

UnitedHealthcare negotiated rates in New Jersey

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

UnitedHealthcare in New Jersey at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
109
9% above the New Jersey median
Rank in state
1 of 4
UHC 109 · Cigna 104 · BCBS 101 · Aetna 82
vs own national
97
UHC's level vs its national median
Codes where highest
43%
of 228 codes
724 sampled providers553 TINs228 codesMedian 167% of Medicare · method

What the data shows

Generated from New Jersey and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in New Jersey with a rate index of 109 (100 = the New Jersey market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for only 43% of codes in New Jersey; UnitedHealthcare leads with an index of 109 in the files analyzed.

3

UnitedHealthcare's New Jersey rates sit 3% below its own national level, the 28th highest of its 51 states.

4

Largest premium over the New Jersey market: CPT 52332 (Cystoscopy and treatment) at 327% of market; largest discount: CPT 96574 (Dbrdmt prmlg les w/pdt) at 71%.

How the four payers compare in New Jersey

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1091
109
43%724
Cigna1042
104
24%795
Blue Cross Blue Shield1013
101
27%787
Aetna824
82
7%807

Where UnitedHealthcare pays most and least against the New Jersey market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
52332
Cystoscopy and treatment
$1,131$346+227%95
52648
Laser surgery of prostate
$3,966$1,563+154%95
51702
Insert temp bladder cath
$146$61+140%95
51700
Irrigation of bladder
$176$82+115%95
52287
Cystoscopy chemodenervation
$793$374+112%95
52281
Cystoscopy and treatment
$701$338+107%95
43255
Egd control bleeding any
$1,042$517+102%112
52000
Cystourethroscopy
$456$231+98%95

Furthest below market

CodeUHCMarketGapProv.
96574
Dbrdmt prmlg les w/pdt
$201$283-29%75
15823
Blepharp upr eyelid xcsv skn
$412$533-23%102
92235
Fluorescein angrph mltiframe
$92$117-21%102
92201
Opscpy extnd rta draw uni/bi
$18$23-21%102
92202
Opscpy extnd on/mac draw
$12$15-21%102
92242
Fluorescein&icg angiography
$194$241-20%102
92134
Cptrz oph dx img pst sgm rta
$32$39-19%102
92025
Cptrized corneal topography
$28$35-19%102

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 New Jersey?

UnitedHealthcare ranks 1st of 4 in New Jersey with an index of 109. It is highest on 43% of codes.

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

About 3% below.

Which procedure does UnitedHealthcare pay most above market in New Jersey?

CPT 52332 (Cystoscopy and treatment), at 327% of the New Jersey 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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