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
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Virginia with a rate index of 116 (100 = the Virginia market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 64% of codes in Virginia.
UnitedHealthcare's Virginia rates sit 7% below its own national level, the 34th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 116 | 1 | 64% | 733 | |
| Cigna | 102 | 2 | 20% | 787 | |
| Aetna | 93 | 3 | 12% | 752 | |
| Blue Cross Blue Shield | 87 | 4 | 4% | 813 |
Where UnitedHealthcare pays most and least against the Virginia market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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
- 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.