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
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Ohio with a rate index of 115 (100 = the Ohio market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 76% of codes in Ohio.
UnitedHealthcare's Ohio rates sit 2% below its own national level, the 26th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 76% | 802 | |
| Blue Cross Blue Shield | 95 | 2 | 13% | 893 | |
| Cigna | 95 | 3 | 5% | 806 | |
| Aetna | 88 | 4 | 6% | 711 |
Where UnitedHealthcare pays most and least against the Ohio market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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
- 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 Ohio?
Compare your negotiated rates for these codes with Ohio medians for each payer.