UnitedHealthcare · West Virginia · commercial in-network

UnitedHealthcare negotiated rates in West Virginia

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

UnitedHealthcare in West Virginia at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
130
30% above the West Virginia median
Rank in state
1 of 4
UHC 130 · Cigna 110 · BCBS 78 · Aetna 76
vs own national
103
UHC's level vs its national median
Codes where highest
70%
of 228 codes
512 sampled providers324 TINs228 codesMedian 174% of Medicare · method

What the data shows

Generated from West Virginia and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in West Virginia with a rate index of 130 (100 = the West Virginia market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for 70% of codes in West Virginia.

3

UnitedHealthcare's West Virginia rates sit 3% above its own national level, the 23rd highest of its 51 states.

4

Largest premium over the West Virginia market: CPT 52648 (Laser surgery of prostate) at 220% of market; largest discount: CPT 96910 (Photchmtx tar&uvb/ptrltm&uvb) at 67%.

How the four payers compare in West Virginia

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1301
130
70%512
Cigna1102
110
30%518
Blue Cross Blue Shield783
78
1%292
Aetna764
76
0%329

Where UnitedHealthcare pays most and least against the West Virginia market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
52648
Laser surgery of prostate
$2,921$1,329+120%42
26055
Incise finger tendon sheath
$1,017$477+114%74
76512
Oph us dx b-scan
$111$60+86%64
92250
Fundus photography w/i&r
$82$45+83%64
43239
Egd biopsy single/multiple
$547$303+80%43
67840
Remove eyelid lesion
$415$234+77%64
51702
Insert temp bladder cath
$115$65+76%42
93971
Extremity study
$274$156+75%89

Furthest below market

CodeUHCMarketGapProv.
96910
Photchmtx tar&uvb/ptrltm&uvb
$72$109-33%30
93229
Remote 30 day ecg tech supp
$747$866-14%69
88342
Imhchem/imcytchm 1st antb
$63$68-8%30
93280
Pm device progr eval dual
$94$100-6%69
77280
Ther rad simulaj field smpl
$292$306-5%30
52649
Prostate laser enucleation
$1,259$1,283-2%42
96413
Chemo iv infusion 1 hr
$189$189+0%43
93312
Echo transesophageal
$352$352+0%69

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 West Virginia?

UnitedHealthcare ranks 1st of 4 in West Virginia with an index of 130. It is highest on 70% of codes.

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

About 3% above.

Which procedure does UnitedHealthcare pay most above market in West Virginia?

CPT 52648 (Laser surgery of prostate), at 220% of the West 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.

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