UnitedHealthcare · Wisconsin · commercial in-network

UnitedHealthcare negotiated rates in Wisconsin

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

UnitedHealthcare in Wisconsin at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
125
25% above the Wisconsin median
Rank in state
1 of 4
UHC 125 · BCBS 114 · Cigna 67 · Aetna 51
vs own national
173
UHC's level vs its national median
Codes where highest
57%
of 228 codes
610 sampled providers323 TINs228 codesMedian 287% of Medicare · method

What the data shows

Generated from Wisconsin and UnitedHealthcare data only
1

UnitedHealthcare ranks 1st of 4 payers in Wisconsin with a rate index of 125 (100 = the Wisconsin market median), across 228 procedure codes.

2

UnitedHealthcare has the highest median for 57% of codes in Wisconsin.

3

UnitedHealthcare's Wisconsin rates sit 73% above its own national level, the 2nd highest of its 51 states.

4

Largest premium over the Wisconsin market: CPT 67840 (Remove eyelid lesion) at 198% of market; largest discount: CPT 88305 (Tissue exam by pathologist) at 75%.

How the four payers compare in Wisconsin

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1251
125
57%610
Blue Cross Blue Shield1142
114
42%733
Cigna673
67
1%296
Aetna514
51
0%291

Where UnitedHealthcare pays most and least against the Wisconsin market

Codes with the largest gap to the state median

Highest above market

CodeUHCMarketGapProv.
67840
Remove eyelid lesion
$757$383+98%67
37243
Vasc embolize/occlude organ
$2,036$1,121+82%76
93656
Compre ep eval abltj atr fib
$3,859$2,134+81%74
65778
Cover eye w/membrane
$156$87+80%62
51720
Treatment of bladder lesion
$289$167+73%87
68761
Close tear duct opening
$481$282+71%69
67108
Repair detached retina
$3,956$2,323+70%69
66991
Xcapsl ctrc rmvl insj 1+
$2,282$1,341+70%69

Furthest below market

CodeUHCMarketGapProv.
88305
Tissue exam by pathologist
$69$91-25%143
88312
Special stains group 1
$102$129-21%143
88313
Special stains group 2
$73$92-20%71
88342
Imhchem/imcytchm 1st antb
$103$128-20%72
93298
Rem interrog dev eval scrms
$70$84-17%74
93297
Rem interrog dev eval icpms
$69$78-12%74
92242
Fluorescein&icg angiography
$454$511-11%69
92235
Fluorescein angrph mltiframe
$199$223-11%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 Wisconsin?

UnitedHealthcare ranks 1st of 4 in Wisconsin with an index of 125. It is highest on 57% of codes.

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

About 73% above.

Which procedure does UnitedHealthcare pay most above market in Wisconsin?

CPT 67840 (Remove eyelid lesion), at 198% of the Wisconsin 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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