UnitedHealthcare negotiated rates in Vermont
How UnitedHealthcare's Vermont rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in Vermont at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Vermont with a rate index of 142 (100 = the Vermont market median), across 222 procedure codes.
UnitedHealthcare has the highest median for 79% of codes in Vermont.
UnitedHealthcare's Vermont rates sit 26% above its own national level, the 12th highest of its 51 states.
Largest premium over the Vermont market: CPT 99487 (Cplx chrnc care 1st 60 min) at 257% of market; largest discount: CPT 77280 (Ther rad simulaj field smpl) at 86%.
How the four payers compare in Vermont
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 142 | 1 | 79% | 279 | |
| Cigna | 109 | 2 | 18% | 302 | |
| Blue Cross Blue Shield | 89 | 3 | 4% | 312 | |
| Aetna | 74 | 4 | 0% | 279 |
Where UnitedHealthcare pays most and least against the Vermont market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 99487 Cplx chrnc care 1st 60 min | $331 | $129 | +157% | 79 |
| 99212 Office o/p est sf 10 min | $133 | $57 | +133% | 279 |
| 52224 Cystoscopy and treatment | $1,135 | $488 | +133% | 15 |
| 20611 Drain/inj joint/bursa w/us | $249 | $108 | +130% | 32 |
| 99490 Chrnc care mgmt staff 1st 20 | $148 | $64 | +129% | 150 |
| 52332 Cystoscopy and treatment | $806 | $356 | +126% | 18 |
| 99215 Office o/p est hi 40 min | $424 | $189 | +124% | 279 |
| 99213 Office o/p est low 20 min | $214 | $96 | +123% | 279 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 77280 Ther rad simulaj field smpl | $290 | $337 | -14% | 19 |
| 66982 Xcapsl ctrc rmvl cplx wo ecp | $1,059 | $1,204 | -12% | 27 |
| 88313 Special stains group 2 | $77 | $87 | -11% | 21 |
| 66984 Xcapsl ctrc rmvl w/o ecp | $772 | $867 | -11% | 27 |
| 92235 Fluorescein angrph mltiframe | $148 | $165 | -10% | 27 |
| 67108 Repair detached retina | $1,691 | $1,830 | -8% | 27 |
| 67036 Removal of inner eye fluid | $1,271 | $1,345 | -6% | 27 |
| 45378 Diagnostic colonoscopy | $522 | $550 | -5% | 21 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in Vermont?
UnitedHealthcare ranks 1st of 4 in Vermont with an index of 142. It is highest on 79% of codes.
Are UnitedHealthcare's Vermont rates above or below its national level?
About 26% above.
Which procedure does UnitedHealthcare pay most above market in Vermont?
CPT 99487 (Cplx chrnc care 1st 60 min), at 257% of the Vermont 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 Vermont?
Compare your negotiated rates for these codes with Vermont medians for each payer.