Commercial healthcare reimbursement in Indiana
How Indiana compares with the nation, by payer, specialty and procedure.
Indiana at a glance
What the data shows
Indiana ranks 47th of 51 states for commercial reimbursement, with an index of 86 (100 = national median) across 228 procedure codes; the Midwest region averages 115.
Commercial rates in Indiana run a median 131% of Medicare.
UnitedHealthcare has the highest index in the state (117) and Aetna the lowest (78), a 40-point gap, in the files analyzed.
CPT 75574 (Ct angio hrt w/3d image) is the strongest relative to the national median (116% of it, a 16% premium); CPT 88313 (Special stains group 2) is furthest below (66% of the national median, 34% lower).
By specialty, Indiana is strongest for ophthalmology (ranks 33rd of 50 states for that specialty) and weakest for orthopedic surgery (47th of 51).
Against Medicare, gastroenterology has the highest ratio in Indiana (157% of Medicare) and dermatology the lowest (86%).
Payer ranking in Indiana
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 117 | 1 | 228 | 805 | 456 | |
| Cigna | 103 | 2 | 228 | 812 | 482 | |
| Blue Cross Blue Shield | 100 | 3 | 228 | 912 | 852 | |
| Aetna | 78 | 4 | 228 | 698 | 514 |
Reimbursement index by specialty in Indiana
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Ophthalmology | 93 | 33 of 50 | 105% | 42 | 116 | |
| Gastroenterology | 92 | 37 of 50 | 157% | 36 | 110 | |
| Internal medicine | 85 | 40 of 51 | 98% | 25 | 123 | |
| Cardiology | 88 | 42 of 51 | 130% | 38 | 122 | |
| Urology | 86 | 44 of 50 | 140% | 37 | 124 | |
| Diagnostic radiology | 86 | 44 of 51 | 125% | 49 | 136 | |
| Dermatology | 84 | 44 of 50 | 86% | 44 | 116 | |
| Orthopedic surgery | 84 | 47 of 51 | 121% | 39 | 115 |
Specialty by payer in Indiana
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 100 | 62 | 86 | 85 |
| Dermatology | 108 | 64 | 87 | 74 |
| Ophthalmology | 97 | 71 | 83 | 102 |
| Cardiology | 98 | 70 | 89 | 95 |
| Orthopedic surgery | 92 | 66 | 92 | 85 |
| Diagnostic radiology | 101 | 56 | 87 | 90 |
| Urology | 102 | 62 | 87 | 89 |
| Gastroenterology | 108 | 62 | 91 | 93 |
Indiana compared with Midwest region states
Procedures that pay most and least in Indiana vs the nation
Highest vs national
| Code | Indiana | National | Gap | Prov. |
|---|---|---|---|---|
| 75574 Ct angio hrt w/3d image | $576 | $495 | +16% | 122 |
| 93015 Cv stress test supvj i&r | $136 | $120 | +13% | 121 |
| 93296 Rem interrog evl pm/ids | $43 | $39 | +11% | 122 |
| 72141 Mri neck spine w/o dye | $428 | $390 | +10% | 135 |
| 45388 Colonoscopy w/ablation | $539 | $492 | +9% | 109 |
| 72148 Mri lumbar spine w/o dye | $404 | $382 | +6% | 250 |
| 43242 Egd us fine needle bx/aspir | $479 | $454 | +6% | 110 |
| 43264 Ercp remove duct calculi | $651 | $622 | +5% | 110 |
| 70551 Mri brain stem w/o dye | $420 | $402 | +4% | 136 |
| 43246 Egd place gastrostomy tube | $352 | $338 | +4% | 110 |
| 52224 Cystoscopy and treatment | $477 | $459 | +4% | 124 |
| 73221 Mri joint upr extrem w/o dye | $412 | $399 | +3% | 250 |
| 73721 Mri jnt of lwr extre w/o dye | $412 | $399 | +3% | 250 |
| 70553 Mri brain stem w/o & w/dye | $617 | $600 | +3% | 136 |
| 70450 Ct head/brain w/o dye | $199 | $194 | +2% | 136 |
Lowest vs national
| Code | Indiana | National | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $46 | $71 | -34% | 109 |
| 88312 Special stains group 1 | $64 | $97 | -34% | 225 |
| 88342 Imhchem/imcytchm 1st antb | $64 | $95 | -32% | 116 |
| 67840 Remove eyelid lesion | $172 | $253 | -32% | 115 |
| 51702 Insert temp bladder cath | $43 | $61 | -30% | 124 |
| 51700 Irrigation of bladder | $54 | $77 | -29% | 124 |
| 93297 Rem interrog dev eval icpms | $37 | $52 | -29% | 122 |
| 71045 X-ray exam chest 1 view | $23 | $33 | -29% | 135 |
| 11102 Tangntl bx skin single les | $46 | $65 | -28% | 116 |
| 52000 Cystourethroscopy | $151 | $210 | -28% | 124 |
| 11104 Punch bx skin single lesion | $58 | $81 | -28% | 116 |
| 93971 Extremity study | $124 | $172 | -28% | 136 |
| 92012 Intrm oph exam est patient | $55 | $76 | -27% | 116 |
| 76536 Us exam of head and neck | $112 | $154 | -27% | 136 |
| 29848 Wrist endoscopy/surgery | $595 | $817 | -27% | 115 |
Frequently asked questions
How do commercial reimbursement rates in Indiana compare with the rest of the country?
Indiana ranks 47th of 51 states with an index of 86, across 228 procedure codes. Median commercial rates run 131% of the Medicare rate.
Which payer has the highest rates in Indiana?
In the files we analyzed, UnitedHealthcare has the highest index (117) and Aetna the lowest (78). 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 Indiana?
Ophthalmology ranks 33rd of 50 states.
How many providers does this Indiana page cover?
962 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 Indiana and the national median?
CPT 75574 (Ct angio hrt w/3d image) is highest relative to the nation at 116% of the national median; CPT 88313 (Special stains group 2) is lowest at 66%.
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 Indiana contracts
Compare your negotiated rates with these state medians by payer and specialty.