UnitedHealthcare negotiated rates in South Dakota
How UnitedHealthcare's South Dakota rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in South Dakota at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in South Dakota with a rate index of 104 (100 = the South Dakota market median), across 228 procedure codes.
UnitedHealthcare has the highest median for only 43% of codes in South Dakota; UnitedHealthcare leads with an index of 104 in the files analyzed.
UnitedHealthcare's South Dakota rates sit 22% above its own national level, the 14th highest of its 51 states.
Largest premium over the South Dakota market: CPT 64566 (Neuroeltrd stim post tibial) at 231% of market; largest discount: CPT 88342 (Imhchem/imcytchm 1st antb) at 35%.
How the four payers compare in South Dakota
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 104 | 1 | 43% | 316 | |
| Cigna | 103 | 2 | 41% | 286 | |
| Blue Cross Blue Shield | 100 | 3 | 20% | 457 | |
| Aetna | 51 | 4 | 0% | 147 |
Where UnitedHealthcare pays most and least against the South Dakota market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 64566 Neuroeltrd stim post tibial | $164 | $71 | +131% | 25 |
| 11104 Punch bx skin single lesion | $248 | $112 | +121% | 25 |
| 11102 Tangntl bx skin single les | $197 | $90 | +119% | 25 |
| 52332 Cystoscopy and treatment | $798 | $364 | +119% | 25 |
| 43239 Egd biopsy single/multiple | $684 | $316 | +117% | 15 |
| 51702 Insert temp bladder cath | $124 | $60 | +109% | 25 |
| 51700 Irrigation of bladder | $146 | $71 | +106% | 25 |
| 43251 Egd remove lesion snare | $877 | $442 | +99% | 15 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 88342 Imhchem/imcytchm 1st antb | $64 | $184 | -65% | 25 |
| 88305 Tissue exam by pathologist | $43 | $121 | -64% | 40 |
| 88312 Special stains group 1 | $68 | $173 | -61% | 40 |
| 88313 Special stains group 2 | $56 | $124 | -55% | 15 |
| 96910 Photchmtx tar&uvb/ptrltm&uvb | $144 | $207 | -30% | 25 |
| 97110 Therapeutic exercises | $33 | $43 | -25% | 71 |
| 76872 Us transrectal | $192 | $251 | -23% | 25 |
| 65820 Goniotomy | $1,493 | $1,754 | -15% | 31 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in South Dakota?
UnitedHealthcare ranks 1st of 4 in South Dakota with an index of 104. It is highest on 43% of codes.
Are UnitedHealthcare's South Dakota rates above or below its national level?
About 22% above.
Which procedure does UnitedHealthcare pay most above market in South Dakota?
CPT 64566 (Neuroeltrd stim post tibial), at 231% of the South 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 South Dakota?
Compare your negotiated rates for these codes with South Dakota medians for each payer.