UnitedHealthcare negotiated rates in Rhode Island
How UnitedHealthcare's Rhode Island rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in Rhode Island at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Rhode Island with a rate index of 129 (100 = the Rhode Island market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 60% of codes in Rhode Island.
UnitedHealthcare's Rhode Island rates sit 4% above its own national level, the 22nd highest of its 51 states.
Largest premium over the Rhode Island market: CPT 52224 (Cystoscopy and treatment) at 343% of market; largest discount: CPT 92025 (Cptrized corneal topography) at 52%.
How the four payers compare in Rhode Island
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 129 | 1 | 60% | 468 | |
| Cigna | 110 | 2 | 26% | 562 | |
| Blue Cross Blue Shield | 90 | 3 | 1% | 581 | |
| Aetna | 87 | 4 | 12% | 422 |
Where UnitedHealthcare pays most and least against the Rhode Island market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 52224 Cystoscopy and treatment | $1,362 | $397 | +243% | 35 |
| 43255 Egd control bleeding any | $1,051 | $381 | +176% | 56 |
| 52332 Cystoscopy and treatment | $810 | $305 | +166% | 35 |
| 64566 Neuroeltrd stim post tibial | $175 | $66 | +165% | 35 |
| 43251 Egd remove lesion snare | $829 | $314 | +164% | 56 |
| 43248 Egd guide wire insertion | $691 | $266 | +159% | 56 |
| 43239 Egd biopsy single/multiple | $631 | $276 | +129% | 56 |
| 52000 Cystourethroscopy | $374 | $173 | +116% | 35 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 92025 Cptrized corneal topography | $21 | $40 | -48% | 52 |
| 92242 Fluorescein&icg angiography | $174 | $289 | -40% | 52 |
| 92235 Fluorescein angrph mltiframe | $103 | $158 | -35% | 52 |
| 66821 After cataract laser surgery | $257 | $370 | -31% | 52 |
| 92083 Extended visual field xm | $50 | $69 | -28% | 52 |
| 92273 Full field erg w/i&r | $103 | $142 | -28% | 52 |
| 92012 Intrm oph exam est patient | $46 | $63 | -27% | 52 |
| 92020 Gonioscopy | $19 | $26 | -26% | 52 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in Rhode Island?
UnitedHealthcare ranks 1st of 4 in Rhode Island with an index of 129. It is highest on 60% of codes.
Are UnitedHealthcare's Rhode Island rates above or below its national level?
About 4% above.
Which procedure does UnitedHealthcare pay most above market in Rhode Island?
CPT 52224 (Cystoscopy and treatment), at 343% of the Rhode Island 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 Rhode Island?
Compare your negotiated rates for these codes with Rhode Island medians for each payer.