UnitedHealthcare negotiated rates in North Dakota
How UnitedHealthcare's North Dakota rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in North Dakota at a glance
What the data shows
UnitedHealthcare ranks 2nd of 4 payers in North Dakota with a rate index of 102 (100 = the North Dakota market median), across 167 procedure codes.
UnitedHealthcare has the highest median for only 28% of codes in North Dakota; Blue Cross Blue Shield leads with an index of 111 in the files analyzed.
UnitedHealthcare's North Dakota rates sit 20% above its own national level, the 15th highest of its 51 states.
Largest premium over the North Dakota market: CPT 43239 (Egd biopsy single/multiple) at 180% of market; largest discount: CPT 93298 (Rem interrog dev eval scrms) at 58%.
How the four payers compare in North Dakota
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 111 | 1 | 68% | 329 | |
| UnitedHealthcare | 102 | 2 | 28% | 210 | |
| Cigna | 81 | 3 | 14% | 71 | |
| Aetna | 54 | 4 | 0% | 211 |
Where UnitedHealthcare pays most and least against the North Dakota market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 43239 Egd biopsy single/multiple | $688 | $381 | +80% | 15 |
| 43251 Egd remove lesion snare | $882 | $502 | +76% | 15 |
| 43248 Egd guide wire insertion | $715 | $428 | +67% | 15 |
| 43235 Egd diagnostic brush wash | $527 | $317 | +66% | 15 |
| 45380 Colonoscopy and biopsy | $810 | $518 | +56% | 15 |
| 45384 Colonoscopy w/lesion removal | $900 | $589 | +53% | 15 |
| 99203 Office o/p new low 30 min | $212 | $147 | +45% | 210 |
| 92014 Compre oph exam est pt 1/> | $216 | $151 | +43% | 22 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $61 | $105 | -42% | 15 |
| 97110 Therapeutic exercises | $31 | $52 | -40% | 23 |
| 76512 Oph us dx b-scan | $65 | $92 | -30% | 22 |
| 92235 Fluorescein angrph mltiframe | $173 | $236 | -27% | 22 |
| 88313 Special stains group 2 | $94 | $119 | -20% | 15 |
| 90960 Esrd srv 4 visits p mo 20+ | $543 | $655 | -17% | 50 |
| 93297 Rem interrog dev eval icpms | $60 | $72 | -17% | 15 |
| 71046 X-ray exam chest 2 views | $48 | $57 | -16% | 46 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in North Dakota?
UnitedHealthcare ranks 2nd of 4 in North Dakota with an index of 102. It is highest on 28% of codes.
Are UnitedHealthcare's North Dakota rates above or below its national level?
About 20% above.
Which procedure does UnitedHealthcare pay most above market in North Dakota?
CPT 43239 (Egd biopsy single/multiple), at 180% of the North Dakota 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 North Dakota?
Compare your negotiated rates for these codes with North Dakota medians for each payer.