UnitedHealthcare negotiated rates in Washington
How UnitedHealthcare's Washington rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
UnitedHealthcare in Washington at a glance
What the data shows
UnitedHealthcare ranks 1st of 4 payers in Washington with a rate index of 106 (100 = the Washington market median), across 228 procedure codes.
UnitedHealthcare has the highest median for 60% of codes in Washington.
UnitedHealthcare's Washington rates sit 28% above its own national level, the 11th highest of its 51 states.
Largest premium over the Washington market: CPT 93298 (Rem interrog dev eval scrms) at 302% of market; largest discount: CPT 76856 (Us exam pelvic complete) at 64%.
How the four payers compare in Washington
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 106 | 1 | 60% | 695 | |
| Cigna | 99 | 2 | 13% | 749 | |
| Blue Cross Blue Shield | 98 | 3 | 8% | 799 | |
| Aetna | 91 | 4 | 19% | 708 |
Where UnitedHealthcare pays most and least against the Washington market
Highest above market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $217 | $72 | +202% | 88 |
| 43255 Egd control bleeding any | $1,239 | $565 | +120% | 81 |
| 52000 Cystourethroscopy | $477 | $252 | +90% | 93 |
| 43251 Egd remove lesion snare | $1,089 | $598 | +82% | 81 |
| 43239 Egd biopsy single/multiple | $831 | $465 | +79% | 81 |
| 52332 Cystoscopy and treatment | $883 | $495 | +78% | 93 |
| 43248 Egd guide wire insertion | $912 | $519 | +76% | 81 |
| 51700 Irrigation of bladder | $169 | $98 | +73% | 93 |
Furthest below market
| Code | UHC | Market | Gap | Prov. |
|---|---|---|---|---|
| 76856 Us exam pelvic complete | $137 | $214 | -36% | 93 |
| 88313 Special stains group 2 | $70 | $99 | -30% | 81 |
| 76872 Us transrectal | $210 | $295 | -29% | 93 |
| 88312 Special stains group 1 | $98 | $136 | -28% | 170 |
| 88342 Imhchem/imcytchm 1st antb | $101 | $130 | -22% | 89 |
| 76857 Us exam pelvic limited | $74 | $95 | -22% | 93 |
| 76775 Us exam abdo back wall lim | $89 | $114 | -22% | 93 |
| 76512 Oph us dx b-scan | $54 | $66 | -18% | 96 |
Where UnitedHealthcare pays above and below its national level
Frequently asked questions
Does UnitedHealthcare pay more or less than the other payers in Washington?
UnitedHealthcare ranks 1st of 4 in Washington with an index of 106. It is highest on 60% of codes.
Are UnitedHealthcare's Washington rates above or below its national level?
About 28% above.
Which procedure does UnitedHealthcare pay most above market in Washington?
CPT 93298 (Rem interrog dev eval scrms), at 302% of the Washington 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 Washington?
Compare your negotiated rates for these codes with Washington medians for each payer.