Commercial healthcare reimbursement in Oregon
How Oregon compares with the nation, by payer, specialty and procedure.
Oregon at a glance
What the data shows
Oregon ranks 3rd of 51 states for commercial reimbursement, with an index of 147 (100 = national median) across 228 procedure codes; the West region averages 118.
Commercial rates in Oregon run a median 206% of Medicare.
UnitedHealthcare has the highest index in the state (121) and Aetna the lowest (71), a 50-point gap, in the files analyzed.
CPT 93298 (Rem interrog dev eval scrms) is the strongest relative to the national median (332% of it, a 232% premium); CPT 74174 (Cta abd&plvs w/contrast) is furthest below (95% of the national median, 5% lower).
By specialty, Oregon is strongest for gastroenterology (ranks 2nd of 50 states for that specialty) and weakest for diagnostic radiology (11th of 51).
Against Medicare, gastroenterology has the highest ratio in Oregon (286% of Medicare) and dermatology the lowest (151%).
Payer ranking in Oregon
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 121 | 1 | 228 | 683 | 399 | |
| Cigna | 100 | 2 | 227 | 735 | 439 | |
| Blue Cross Blue Shield | 90 | 3 | 228 | 351 | 423 | |
| Aetna | 71 | 4 | 225 | 494 | 467 |
Reimbursement index by specialty in Oregon
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Gastroenterology | 188 | 2 of 50 | 286% | 36 | 104 | |
| Internal medicine | 158 | 3 of 51 | 175% | 25 | 99 | |
| Urology | 163 | 3 of 50 | 282% | 37 | 105 | |
| Ophthalmology | 164 | 3 of 50 | 183% | 42 | 100 | |
| Dermatology | 158 | 4 of 50 | 151% | 44 | 108 | |
| Cardiology | 140 | 4 of 51 | 214% | 38 | 92 | |
| Orthopedic surgery | 123 | 11 of 51 | 179% | 39 | 94 | |
| Diagnostic radiology | 115 | 11 of 51 | 177% | 49 | 107 |
Specialty by payer in Oregon
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 227 | 97 | 171 | 118 |
| Dermatology | 252 | 102 | 157 | 140 |
| Ophthalmology | 223 | 114 | 190 | 128 |
| Cardiology | 172 | 102 | 159 | 107 |
| Orthopedic surgery | 131 | 99 | 128 | 122 |
| Diagnostic radiology | 126 | 119 | 104 | 110 |
| Urology | 215 | 112 | 166 | 146 |
| Gastroenterology | 251 | 89 | 159 | 231 |
Oregon compared with West region states
Procedures that pay most and least in Oregon vs the nation
Highest vs national
| Code | Oregon | National | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $174 | $52 | +232% | 92 |
| 45384 Colonoscopy w/lesion removal | $1,533 | $519 | +195% | 104 |
| 43235 Egd diagnostic brush wash | $772 | $294 | +163% | 104 |
| 45380 Colonoscopy and biopsy | $1,159 | $470 | +147% | 104 |
| 76872 Us transrectal | $428 | $188 | +127% | 103 |
| 46221 Ligation of hemorrhoid(s) | $779 | $346 | +125% | 104 |
| 45378 Diagnostic colonoscopy | $916 | $408 | +125% | 104 |
| 92242 Fluorescein&icg angiography | $603 | $288 | +109% | 99 |
| 99490 Chrnc care mgmt staff 1st 20 | $121 | $60 | +101% | 396 |
| 93297 Rem interrog dev eval icpms | $102 | $52 | +96% | 92 |
| 92273 Full field erg w/i&r | $278 | $142 | +96% | 99 |
| 91110 Gi trc img intral esoph-ile | $2,252 | $1,175 | +92% | 104 |
| 43276 Ercp stent exchange w/dilate | $1,471 | $771 | +91% | 104 |
| 99487 Cplx chrnc care 1st 60 min | $231 | $121 | +90% | 98 |
| 43251 Egd remove lesion snare | $800 | $425 | +88% | 102 |
Lowest vs national
| Code | Oregon | National | Gap | Prov. |
|---|---|---|---|---|
| 74174 Cta abd&plvs w/contrast | $570 | $601 | -5% | 106 |
| 70498 Ct angiography neck | $445 | $459 | -3% | 106 |
| 70496 Ct angiography head | $445 | $457 | -2% | 106 |
| 71275 Ct angiography chest | $451 | $462 | -2% | 106 |
| 77049 Mri breast c-+ w/cad bi | $550 | $558 | -2% | 106 |
| 74177 Ct abd & pelvis w/contrast | $445 | $448 | -1% | 106 |
| 97110 Therapeutic exercises | $31 | $31 | +0% | 93 |
| 70553 Mri brain stem w/o & w/dye | $603 | $600 | +0% | 106 |
| 74183 Mri abd w/o cntr flwd cntr | $640 | $634 | +1% | 106 |
| 72158 Mri lumbar spine w/o & w/dye | $603 | $593 | +2% | 106 |
| 72197 Mri pelvis w/o & w/dye | $645 | $634 | +2% | 106 |
| 52000 Cystourethroscopy | $216 | $210 | +3% | 103 |
| 70551 Mri brain stem w/o dye | $414 | $402 | +3% | 106 |
| 72141 Mri neck spine w/o dye | $403 | $390 | +3% | 106 |
| 51700 Irrigation of bladder | $81 | $77 | +5% | 101 |
Frequently asked questions
How do commercial reimbursement rates in Oregon compare with the rest of the country?
Oregon ranks 3rd of 51 states with an index of 147, across 228 procedure codes. Median commercial rates run 206% of the Medicare rate.
Which payer has the highest rates in Oregon?
In the files we analyzed, UnitedHealthcare has the highest index (121) and Aetna the lowest (71). 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 Oregon?
Gastroenterology ranks 2nd of 50 states.
How many providers does this Oregon page cover?
809 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 Oregon and the national median?
CPT 93298 (Rem interrog dev eval scrms) is highest relative to the nation at 332% of the national median; CPT 74174 (Cta abd&plvs w/contrast) is lowest at 95%.
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 Oregon contracts
Compare your negotiated rates with these state medians by payer and specialty.