UnitedHealthcare · Ohio · commercial in-network

UnitedHealthcare negotiated rates in Ohio

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

UnitedHealthcare in Ohio at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
115
15% above the Ohio median
Rank in state
1 of 4
UHC 115 · BCBS 95 · Cigna 95 · Aetna 88
vs own national
98
UHC's level vs its national median
Codes where highest
76%
of 228 codes
802 sampled providers496 TINs228 codesMedian 169% of Medicare · method

What the data shows

Generated from Ohio and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in Ohio with a rate index of 115 (100 = the Ohio market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for 76% of codes in Ohio.

3

UnitedHealthcare's Ohio rates sit 2% below its own national level, the 26th highest of its 51 states.

4

Largest premium over the Ohio market: CPT 52224 (Cystoscopy and treatment) at 284% of market; largest discount: CPT 96413 (Chemo iv infusion 1 hr) at 74%.

How the four payers compare in Ohio

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1151
115
76%802
Blue Cross Blue Shield952
95
13%893
Cigna953
95
5%806
Aetna884
88
6%711

Where UnitedHealthcare pays most and least against the Ohio market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
52224
Cystoscopy and treatment
$1,128$398+184%87
52332
Cystoscopy and treatment
$806$329+145%101
52648
Laser surgery of prostate
$3,217$1,466+120%100
43251
Egd remove lesion snare
$793$378+110%107
43248
Egd guide wire insertion
$647$331+96%107
43255
Egd control bleeding any
$823$435+89%96
64566
Neuroeltrd stim post tibial
$144$76+89%87
51702
Insert temp bladder cath
$117$65+80%101

Furthest below market

CodeUHCMarketGapProv.
96413
Chemo iv infusion 1 hr
$162$219-26%107
65778
Cover eye w/membrane
$63$77-18%79
92235
Fluorescein angrph mltiframe
$116$140-17%92
93298
Rem interrog dev eval scrms
$56$67-16%106
72110
X-ray exam l-2 spine 4/>vws
$55$64-15%98
88305
Tissue exam by pathologist
$68$78-13%210
76512
Oph us dx b-scan
$64$73-12%92
73030
X-ray exam of shoulder
$38$43-12%98

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 Ohio?

UnitedHealthcare ranks 1st of 4 in Ohio with an index of 115. It is highest on 76% of codes.

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

About 2% below.

Which procedure does UnitedHealthcare pay most above market in Ohio?

CPT 52224 (Cystoscopy and treatment), at 284% of the Ohio 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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