UnitedHealthcare · Virginia · commercial in-network

UnitedHealthcare negotiated rates in Virginia

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

UnitedHealthcare in Virginia at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
116
16% above the Virginia median
Rank in state
1 of 4
UHC 116 · Cigna 102 · Aetna 93 · BCBS 87
vs own national
93
UHC's level vs its national median
Codes where highest
64%
of 228 codes
733 sampled providers542 TINs228 codesMedian 164% of Medicare · method

What the data shows

Generated from Virginia and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in Virginia with a rate index of 116 (100 = the Virginia market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for 64% of codes in Virginia.

3

UnitedHealthcare's Virginia rates sit 7% below its own national level, the 34th highest of its 51 states.

4

Largest premium over the Virginia market: CPT 52224 (Cystoscopy and treatment) at 276% of market; largest discount: CPT 92235 (Fluorescein angrph mltiframe) at 76%.

How the four payers compare in Virginia

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1161
116
64%733
Cigna1022
102
20%787
Aetna933
93
12%752
Blue Cross Blue Shield874
87
4%813

Where UnitedHealthcare pays most and least against the Virginia market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
52224
Cystoscopy and treatment
$1,041$378+176%87
43255
Egd control bleeding any
$1,008$423+138%105
52332
Cystoscopy and treatment
$737$325+127%87
52648
Laser surgery of prostate
$2,964$1,329+123%87
11104
Punch bx skin single lesion
$131$61+117%102
11102
Tangntl bx skin single les
$105$49+114%102
51702
Insert temp bladder cath
$116$59+97%87
43251
Egd remove lesion snare
$739$378+95%105

Furthest below market

CodeUHCMarketGapProv.
92235
Fluorescein angrph mltiframe
$110$145-24%85
92242
Fluorescein&icg angiography
$247$298-17%85
93297
Rem interrog dev eval icpms
$40$46-14%108
65820
Goniotomy
$795$868-8%85
72110
X-ray exam l-2 spine 4/>vws
$61$66-8%94
72148
Mri lumbar spine w/o dye
$372$405-8%159
93298
Rem interrog dev eval scrms
$42$45-8%108
96910
Photchmtx tar&uvb/ptrltm&uvb
$111$121-8%103

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 Virginia?

UnitedHealthcare ranks 1st of 4 in Virginia with an index of 116. It is highest on 64% of codes.

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

About 7% below.

Which procedure does UnitedHealthcare pay most above market in Virginia?

CPT 52224 (Cystoscopy and treatment), at 276% of the Virginia 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.

Is your UnitedHealthcare contract at market in Virginia?

Compare your negotiated rates for these codes with Virginia medians for each payer.

Request a rate benchmark