Commercial healthcare reimbursement in Nevada
How Nevada compares with the nation, by payer, specialty and procedure.
Nevada at a glance
What the data shows
Nevada ranks 43rd of 51 states for commercial reimbursement, with an index of 87 (100 = national median) across 228 procedure codes; the West region averages 118.
Commercial rates in Nevada run a median 128% of Medicare.
UnitedHealthcare has the highest index in the state (110) and Aetna the lowest (87), a 23-point gap, in the files analyzed.
CPT 76775 (Us exam abdo back wall lim) is the strongest relative to the national median (119% of it, a 19% premium); CPT 93297 (Rem interrog dev eval icpms) is furthest below (58% of the national median, 42% lower).
By specialty, Nevada is strongest for urology (ranks 27th of 50 states for that specialty) and weakest for gastroenterology (50th of 50).
Against Medicare, urology has the highest ratio in Nevada (180% of Medicare) and internal medicine the lowest (86%).
Payer ranking in Nevada
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 110 | 1 | 228 | 629 | 413 | |
| Blue Cross Blue Shield | 105 | 2 | 227 | 277 | 406 | |
| Cigna | 100 | 3 | 227 | 657 | 402 | |
| Aetna | 87 | 4 | 226 | 615 | 456 |
Reimbursement index by specialty in Nevada
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Urology | 102 | 27 of 50 | 180% | 37 | 57 | |
| Dermatology | 98 | 28 of 50 | 95% | 44 | 67 | |
| Ophthalmology | 88 | 37 of 50 | 104% | 42 | 113 | |
| Diagnostic radiology | 90 | 41 of 51 | 140% | 49 | 123 | |
| Orthopedic surgery | 86 | 44 of 51 | 129% | 39 | 109 | |
| Internal medicine | 74 | 49 of 51 | 86% | 25 | 111 | |
| Cardiology | 76 | 50 of 51 | 115% | 38 | 116 | |
| Gastroenterology | 76 | 50 of 50 | 141% | 36 | 84 |
Specialty by payer in Nevada
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 84 | 65 | 69 | 83 |
| Dermatology | 115 | 70 | 87 | 99 |
| Ophthalmology | 95 | 82 | 91 | 97 |
| Cardiology | 86 | 72 | 82 | 81 |
| Orthopedic surgery | 90 | 75 | 89 | 130 |
| Diagnostic radiology | 102 | 81 | 91 | 89 |
| Urology | 111 | 87 | 107 | 89 |
| Gastroenterology | 103 | 62 | 72 | 88 |
Nevada compared with West region states
| State | Index | Rank | % of Medicare | Providers | Level |
|---|---|---|---|---|---|
| Nevada | 87 | 43 | 128% | 780 | |
| Arizona | 83 | 48 | 122% | 820 | |
| California | 93 | 35 | 138% | 844 | |
| New Mexico | 94 | 33 | 141% | 622 | |
| Utah | 100 | 25 | 154% | 818 | |
| Montana | 100 | 24 | 160% | 448 |
Procedures that pay most and least in Nevada vs the nation
Highest vs national
| Code | Nevada | National | Gap | Prov. |
|---|---|---|---|---|
| 76775 Us exam abdo back wall lim | $110 | $92 | +19% | 57 |
| 76857 Us exam pelvic limited | $85 | $75 | +14% | 54 |
| 51728 Cystometrogram w/vp | $581 | $520 | +12% | 57 |
| 99426 Prin care mgmt staff 1st 30 | $84 | $77 | +9% | 54 |
| 51798 Us urine capacity measure | $23 | $21 | +8% | 55 |
| 55874 Tprnl plmt biodegrdabl matrl | $275 | $257 | +7% | 57 |
| 52356 Cysto/uretero w/lithotripsy | $701 | $657 | +7% | 57 |
| 17110 Destruction b9 les up to 14 | $105 | $101 | +4% | 65 |
| 17313 Mohs 1 stage t/a/l | $530 | $515 | +3% | 65 |
| 17261 Dstrj mal les t/a/l .6-1.0cm | $135 | $132 | +2% | 65 |
| 76856 Us exam pelvic complete | $151 | $148 | +2% | 54 |
| 17262 Dstrj mal les t/a/l 1.1-2.0 | $166 | $163 | +2% | 65 |
| 11302 Shave skin lesion 1.1-2.0 cm | $100 | $98 | +1% | 65 |
| 17282 Dstr mal ls f/e/e/n/l/m1.1-2 | $198 | $195 | +1% | 65 |
| 11301 Shave skin lesion 0.6-1.0 cm | $86 | $85 | +1% | 65 |
Lowest vs national
| Code | Nevada | National | Gap | Prov. |
|---|---|---|---|---|
| 93297 Rem interrog dev eval icpms | $30 | $52 | -42% | 116 |
| 43251 Egd remove lesion snare | $272 | $425 | -36% | 84 |
| 43248 Egd guide wire insertion | $236 | $364 | -35% | 84 |
| 93298 Rem interrog dev eval scrms | $34 | $52 | -35% | 116 |
| 88313 Special stains group 2 | $46 | $71 | -34% | 84 |
| 43239 Egd biopsy single/multiple | $230 | $349 | -34% | 84 |
| 88312 Special stains group 1 | $65 | $97 | -34% | 149 |
| 43255 Egd control bleeding any | $310 | $459 | -32% | 84 |
| 45380 Colonoscopy and biopsy | $325 | $470 | -31% | 84 |
| 45384 Colonoscopy w/lesion removal | $367 | $519 | -29% | 84 |
| 36465 Njx noncmpnd sclrsnt 1 vein | $132 | $185 | -29% | 115 |
| 33208 Insrt heart pm atrial & vent | $585 | $819 | -29% | 116 |
| 46221 Ligation of hemorrhoid(s) | $248 | $346 | -28% | 84 |
| 99350 Home/res vst est high mdm 60 | $177 | $247 | -28% | 106 |
| 43264 Ercp remove duct calculi | $451 | $622 | -28% | 84 |
Frequently asked questions
How do commercial reimbursement rates in Nevada compare with the rest of the country?
Nevada ranks 43rd of 51 states with an index of 87, across 228 procedure codes. Median commercial rates run 128% of the Medicare rate.
Which payer has the highest rates in Nevada?
In the files we analyzed, UnitedHealthcare has the highest index (110) and Aetna the lowest (87). 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 Nevada?
Urology ranks 27th of 50 states.
How many providers does this Nevada page cover?
780 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 Nevada and the national median?
CPT 76775 (Us exam abdo back wall lim) is highest relative to the nation at 119% of the national median; CPT 93297 (Rem interrog dev eval icpms) is lowest at 58%.
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 Nevada contracts
Compare your negotiated rates with these state medians by payer and specialty.