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
What the data shows
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.
UnitedHealthcare has the highest median for only 43% of codes in New Jersey; UnitedHealthcare leads with an index of 109 in the files analyzed.
UnitedHealthcare's New Jersey rates sit 3% below its own national level, the 28th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 109 | 1 | 43% | 724 | |
| Cigna | 104 | 2 | 24% | 795 | |
| Blue Cross Blue Shield | 101 | 3 | 27% | 787 | |
| Aetna | 82 | 4 | 7% | 807 |
Where UnitedHealthcare pays most and least against the New Jersey market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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
- 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 New Jersey?
Compare your negotiated rates for these codes with New Jersey medians for each payer.