Commercial healthcare reimbursement in Florida
How Florida compares with the nation, by payer, specialty and procedure.
Florida at a glance
What the data shows
Florida ranks 51st of 51 states for commercial reimbursement, with an index of 78 (100 = national median) across 228 procedure codes; the South region averages 94.
Commercial rates in Florida run a median 119% of Medicare.
UnitedHealthcare has the highest index in the state (112) and Aetna the lowest (85), a 27-point gap, in the files analyzed.
CPT 64566 (Neuroeltrd stim post tibial) comes closest to the national median (99% of it); CPT 76512 (Oph us dx b-scan) is furthest below (50% of the national median, 50% lower).
By specialty, Florida is strongest for diagnostic radiology (ranks 40th of 51 states for that specialty) and weakest for ophthalmology (50th of 50).
Against Medicare, gastroenterology has the highest ratio in Florida (157% of Medicare) and dermatology the lowest (74%).
Payer ranking in Florida
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 112 | 1 | 228 | 744 | 616 | |
| Blue Cross Blue Shield | 107 | 2 | 166 | 200 | 392 | |
| Cigna | 96 | 3 | 227 | 775 | 744 | |
| Aetna | 85 | 4 | 228 | 758 | 723 |
Reimbursement index by specialty in Florida
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Diagnostic radiology | 90 | 40 of 51 | 138% | 49 | 112 | |
| Urology | 86 | 43 of 50 | 136% | 37 | 112 | |
| Gastroenterology | 87 | 43 of 50 | 157% | 36 | 121 | |
| Internal medicine | 75 | 48 of 51 | 89% | 25 | 105 | |
| Dermatology | 75 | 49 of 50 | 74% | 44 | 114 | |
| Cardiology | 78 | 49 of 51 | 115% | 38 | 111 | |
| Orthopedic surgery | 78 | 49 of 51 | 108% | 39 | 108 | |
| Ophthalmology | 68 | 50 of 50 | 79% | 42 | 113 |
Specialty by payer in Florida
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 98 | 64 | 71 | 86 |
| Dermatology | 88 | 65 | 69 | 90 |
| Ophthalmology | 77 | 63 | 63 | n/a |
| Cardiology | 90 | 65 | 75 | 84 |
| Orthopedic surgery | 85 | 63 | 79 | 94 |
| Diagnostic radiology | 96 | 79 | 100 | 77 |
| Urology | 115 | 66 | 79 | 90 |
| Gastroenterology | 108 | 74 | 77 | 90 |
Florida compared with South region states
Procedures that pay most and least in Florida vs the nation
Highest vs national
| Code | Florida | National | Gap | Prov. |
|---|---|---|---|---|
| 64566 Neuroeltrd stim post tibial | $69 | $69 | -1% | 111 |
| 72125 Ct neck spine w/o dye | $246 | $249 | -1% | 104 |
| 72131 Ct lumbar spine w/o dye | $239 | $248 | -4% | 104 |
| 99426 Prin care mgmt staff 1st 30 | $74 | $77 | -4% | 111 |
| 71271 Ct thorax lung cancer scr c- | $200 | $208 | -4% | 104 |
| 37243 Vasc embolize/occlude organ | $809 | $858 | -6% | 108 |
| 76705 Echo exam of abdomen | $119 | $126 | -6% | 107 |
| 71260 Ct thorax dx c+ | $291 | $312 | -7% | 104 |
| 76700 Us exam abdom complete | $156 | $168 | -7% | 107 |
| 71250 Ct thorax dx c- | $233 | $250 | -7% | 104 |
| 93971 Extremity study | $160 | $172 | -7% | 109 |
| 74176 Ct abd & pelvis w/o contrast | $264 | $287 | -8% | 105 |
| 45390 Colonoscopy w/resection | $486 | $532 | -9% | 117 |
| 77066 Dx mammo incl cad bi | $205 | $225 | -9% | 107 |
| 77067 Scr mammo bi incl cad | $165 | $182 | -9% | 107 |
Lowest vs national
| Code | Florida | National | Gap | Prov. |
|---|---|---|---|---|
| 76512 Oph us dx b-scan | $35 | $70 | -50% | 112 |
| 72100 X-ray exam l-s spine 2/3 vws | $32 | $53 | -41% | 108 |
| 72110 X-ray exam l-2 spine 4/>vws | $42 | $71 | -41% | 108 |
| 75574 Ct angio hrt w/3d image | $297 | $495 | -40% | 106 |
| 73564 X-ray exam knee 4 or more | $36 | $60 | -40% | 108 |
| 67108 Repair detached retina | $968 | $1,594 | -39% | 111 |
| 66984 Xcapsl ctrc rmvl w/o ecp | $449 | $738 | -39% | 112 |
| 73030 X-ray exam of shoulder | $27 | $45 | -39% | 108 |
| 73630 X-ray exam of foot | $27 | $44 | -39% | 108 |
| 73562 X-ray exam of knee 3 | $32 | $53 | -39% | 108 |
| 73610 X-ray exam of ankle | $29 | $47 | -38% | 108 |
| 78452 Ht muscle image spect mult | $382 | $617 | -38% | 214 |
| 67028 Injection eye drug | $85 | $137 | -38% | 112 |
| 73560 X-ray exam of knee 1 or 2 | $28 | $45 | -38% | 108 |
| 67042 Vit for macular hole | $930 | $1,494 | -38% | 111 |
Frequently asked questions
How do commercial reimbursement rates in Florida compare with the rest of the country?
Florida ranks 51st of 51 states with an index of 78, across 228 procedure codes. Median commercial rates run 119% of the Medicare rate.
Which payer has the highest rates in Florida?
In the files we analyzed, UnitedHealthcare has the highest index (112) and Aetna the lowest (85). Each payer's figures describe the specific plans and networks in the files used, not its whole book of business.
Which specialty has the strongest rates in Florida?
Diagnostic radiology ranks 40th of 51 states.
How many providers does this Florida page cover?
896 sampled providers across 4 payers. The data comes from a random sample of providers, so counts describe the sample, not every provider in the state.
Which procedures differ most between Florida and the national median?
CPT 64566 (Neuroeltrd stim post tibial) is highest relative to the nation at 99% of the national median; CPT 76512 (Oph us dx b-scan) is lowest at 50%.
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.
Benchmark your Florida contracts
Compare your negotiated rates with these state medians by payer and specialty.