What do payers pay neurology groups in CA?

Across 847 NPIs, the median published rate is 133.9% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 86 procedure codes and 3 payers, the median published rate is 115 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 145 percent and Aetna the lowest at 95 percent, a spread of 50 points on identical work. 2 of 3 payers sit at or above Medicare and 1 below it. The best-covered row rests on 847 confirmed NPIs, and any combination under five is withheld rather than shown thin. These are contracted amounts the payer published, not what a practice was paid, and every row clears the ghost-rate filter, so each NPI counted here actually billed the code in the Medicare utilization file.

Published rates

What do payers pay neurology groups in CA?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
UnitedHealthcare	99214	professional	847	88.76	177.05	251.73	133.9%
UnitedHealthcare	99215	professional	830	185.16	314.79	549.57	153.3%
Cigna	99214	professional	821	101.74	188.07	331.22	122.3%
Cigna	99215	professional	807	175.55	295.23	572.58	140.1%
Aetna	99214	professional	647	41	82.84	122.48	70.7%
UnitedHealthcare	99205	professional	636	192.2	382.95	631.75	157.8%
Cigna	99205	professional	619	236.32	384.26	637.67	140.4%
Aetna	99215	professional	563	41	117.32	163.87	67.3%
Aetna	99205	professional	451	41	124.75	231.38	78.1%
UnitedHealthcare	99213	professional	408	85	118.61	169.37	115.5%
UnitedHealthcare	99204	professional	400	129.64	228.23	322.49	109.8%
Cigna	99213	professional	389	71.94	122.21	223.64	113.3%
Cigna	99204	professional	386	143.78	199.49	319.4	102.8%
Aetna	99204	professional	348	42.03	87.96	180.49	82.7%
Aetna	99213	professional	314	39.07	61.92	82.88	70.5%
UnitedHealthcare	95886	professional	297	52.5	94.89	185.54	121.2%
Cigna	95886	professional	289	56.67	106.36	167.81	126.2%
Aetna	95886	professional	254	44.96	59.14	92.4	95.3%
Cigna	95816	professional	232	138.84	333.63	628.91	111.6%
UnitedHealthcare	95816	professional	232	145.53	289.99	724.75	131.6%
Aetna	95816	professional	204	72.33	267.57	379.51	87.9%
UnitedHealthcare	95819	professional	204	127.53	327.98	754.21	107%
Cigna	95819	professional	201	118.67	347.01	572.22	97%
Aetna	95819	professional	185	73.91	312.61	450.25	88.7%
UnitedHealthcare	64615	professional	153	209.63	323.3	640.97	199.8%
UnitedHealthcare	95911	professional	152	135.69	242.85	471.17	134.8%
Cigna	64615	professional	150	171.33	287.35	726.8	181.9%
Cigna	95911	professional	146	157.48	272.09	437.43	169%
Cigna	95910	professional	142	125.1	227.56	428.19	170.1%
UnitedHealthcare	95910	professional	136	114.66	215.52	433.69	155.7%
Aetna	64615	professional	121	23.79	89.22	132.85	85.8%
Aetna	95911	professional	121	112.04	151.84	234	100.9%
UnitedHealthcare	95913	professional	111	158.4	263.29	518.34	105.6%
Cigna	95913	professional	109	199.12	325.25	507.66	128.7%
Aetna	95910	professional	106	91.32	121.61	185.73	98.9%
Aetna	95913	professional	100	139.46	189.39	305.64	98.5%
UnitedHealthcare	95720	professional	94	519.1	796.92	967.07	328.8%
UnitedHealthcare	95912	professional	94	141.88	266.77	541.54	121.2%
Cigna	95720	professional	92	345.2	560.5	831.12	247.7%
Cigna	95885	professional	91	55.68	105.95	164.13	229.3%
UnitedHealthcare	95885	professional	91	52.72	86.96	185.41	240.2%
Cigna	95912	professional	88	193.5	321.8	658.35	199.4%
UnitedHealthcare	99203	professional	84	93.97	150.91	180.75	114.8%
Cigna	95909	professional	81	110.64	187.22	352.19	182.6%
UnitedHealthcare	95909	professional	80	98.82	165.35	325.54	166%
Aetna	95912	professional	79	124.4	169.05	262.69	101%
Cigna	99203	professional	78	95.33	144.08	211.67	110.4%
Aetna	99203	professional	73	40.38	55.1	110.09	80.2%
Cigna	95874	professional	68	53.61	102.8	188.18	196.6%
UnitedHealthcare	95874	professional	68	68.13	108.86	272.17	249.8%
UnitedHealthcare	95718	professional	67	330.09	538.78	640.12	326.8%
Cigna	95718	professional	65	218.53	362.14	536.98	246.2%
Aetna	95885	professional	64	25.72	51.89	75.41	108.5%
Aetna	95909	professional	63	73.89	101.2	153.47	110.7%
Cigna	64616	professional	57	147.2	224.73	361.51	145.8%
Aetna	95720	professional	57	116.05	226.89	276.27	105.8%
UnitedHealthcare	99212	professional	56	68.87	89.46	127.3	144.9%
UnitedHealthcare	64616	professional	55	159.61	297.22	470.45	201.6%
Cigna	95822	professional	53	180.22	568.37	1071.12	177.4%
Cigna	99212	professional	53	61.46	87.31	187.49	127.9%
UnitedHealthcare	95822	professional	52	232.39	461.59	1440.9	192.6%
Aetna	64616	professional	51	21.02	73.54	105.06	83.2%
Cigna	95938	professional	49	132.67	421.62	882.02	153.7%
UnitedHealthcare	95938	professional	46	184.87	430.95	1046.02	213.4%
Cigna	95939	professional	46	349.7	649.66	1241.51	165%
Cigna	95861	professional	45	112.6	193.09	282.1	147.2%
Aetna	99212	professional	45	15.36	40.28	48	65.5%
UnitedHealthcare	95861	professional	44	130.82	231.84	417.02	190%
UnitedHealthcare	95939	professional	44	377.9	636.82	1560.29	200.4%
Aetna	96132	professional	42	56.34	124.99	128.31	97.4%
Cigna	96132	professional	42	122.41	136.02	156.54	103.6%
UnitedHealthcare	99483	professional	42	174.58	213.57	538.91	68.1%
Cigna	95983	professional	41	83.75	129.71	190.24	235.3%
UnitedHealthcare	64612	professional	40	199.69	369.04	557	237.4%
UnitedHealthcare	95983	professional	40	95.49	144.13	217.07	260.5%
Cigna	99483	professional	40	218.31	239.6	456.08	76.5%
Cigna	64612	professional	39	201.1	317.02	417.36	183.6%
Cigna	64405	professional	38	94.35	119.63	293.5	148.9%
Aetna	95874	professional	38	32.17	59.38	85.2	97.9%
UnitedHealthcare	96116	professional	38	69.66	102.81	244.83	103.5%
UnitedHealthcare	96132	professional	38	96.18	112.43	174.69	87.1%
UnitedHealthcare	64405	professional	37	79.04	99.11	225.86	194.6%
Cigna	96116	professional	37	94.39	123.34	178.9	113.1%
Aetna	99483	professional	36	108.6	192.82	218.1	64.5%
Aetna	64405	professional	35	17.78	44.45	86.69	121.3%
Aetna	95718	professional	35	71.4	142	170.37	103.5%
UnitedHealthcare	64642	professional	34	212.54	368.37	601.08	213.1%
Aetna	95822	professional	34	82.14	301.42	502.73	95.8%
Aetna	96116	professional	34	87.68	110.19	125.71	89.5%
Aetna	64612	professional	33	32.56	74.9	131.51	112.2%
Aetna	96372	professional	33	23.46	25.1	29.74	145.6%
Cigna	64642	professional	32	201.58	307.26	439.39	158.3%
Cigna	96372	professional	32	25.8	27.26	34.14	161.4%
UnitedHealthcare	96372	professional	32	12.3	22.16	34.36	125.7%
Aetna	95938	professional	31	69.61	272.51	352.65	87%
Aetna	96138	professional	31	36.68	39.7	42.63	91.7%
Aetna	64642	professional	30	17.13	57.08	114.15	100.8%
Aetna	95861	professional	30	74.94	89.14	149.96	95.1%
Cigna	95970	professional	30	39.59	82.01	177.15	389.5%
UnitedHealthcare	95970	professional	30	48.16	68.75	90.9	326.5%
Aetna	20553	professional	29	9.41	35.29	47.05	111.1%
Aetna	95939	professional	29	126.97	366.43	502.82	86.9%
Cigna	96138	professional	29	42.63	45.81	50.16	106.5%
Cigna	95813	professional	28	207.46	481.73	765.06	119.9%
UnitedHealthcare	95813	professional	27	235.7	387.72	954.64	145.9%
UnitedHealthcare	96138	professional	26	29.96	37.21	56.35	87%
UnitedHealthcare	93880	professional	24	52.75	157.92	247.88	102.8%
UnitedHealthcare	93886	professional	24	161.51	228.04	507.37	113.3%
UnitedHealthcare	95717	professional	24	163.96	175.59	388.53	154%
Aetna	95813	professional	24	123.42	342.78	502.87	96.5%
Cigna	93886	professional	23	141.47	316.18	638.55	170.7%
Cigna	95717	professional	23	149.55	189.25	320.87	166%
Cigna	93880	professional	22	69.81	227.49	329.08	131.1%
Aetna	95983	professional	22	31.44	60.77	90.71	121.5%
Cigna	20553	professional	21	50.67	73.51	122.42	128.1%
UnitedHealthcare	20553	professional	21	44.27	71.7	131.51	156.6%
UnitedHealthcare	64450	professional	21	81.79	98.59	210.2	201.1%
Aetna	64450	professional	20	16.08	41	60.29	147.8%
Aetna	64644	professional	20	19.22	64.07	126.82	107.8%
Aetna	93880	professional	20	39.46	161.31	199.63	95.8%
Aetna	93886	professional	20	48.56	145.2	251.25	87.1%
Aetna	95887	professional	20	38.41	44.36	73.02	89.1%
UnitedHealthcare	95887	professional	20	40.96	70.5	103.14	98.3%
UnitedHealthcare	95937	professional	20	63.36	100.49	175.43	128.7%
Cigna	64450	professional	18	77.63	142.54	362.48	155.3%
UnitedHealthcare	64644	professional	18	203.4	336.5	651	186.5%
Cigna	95870	professional	18	36.23	95.93	168.79	143.9%
Cigna	95887	professional	18	44.94	73.61	102.12	99%
Cigna	95937	professional	18	53.11	95.79	161.34	139.2%
Cigna	95984	professional	18	60.11	92.45	165.26	194%
Aetna	96139	professional	18	33.99	39.88	42.12	101.5%
Aetna	20552	professional	17	8.11	31.28	41	147.9%
Cigna	64644	professional	17	164.34	232.72	371.44	122.6%
Aetna	95717	professional	17	52.8	112.43	133.59	103.7%
Cigna	95810	professional	17	381.01	678.9	1048.94	114%
Cigna	95908	professional	17	87.41	128.49	299.42	146.6%
UnitedHealthcare	95908	professional	17	55.68	109.38	237.49	152.1%
UnitedHealthcare	95984	professional	17	61.13	112.75	213.99	233.3%
Aetna	62270	professional	16	19.54	45.1	83.18	33.2%
UnitedHealthcare	64643	professional	16	166.28	260.03	374.29	240.4%
UnitedHealthcare	95810	professional	16	441.38	651.65	1138.22	124.9%
Aetna	95970	professional	16	28.28	40.73	46.86	186.3%
UnitedHealthcare	36224	professional	15	1119.78	1424.61	2003.62	59.7%
UnitedHealthcare	36226	professional	15	1072.66	1362.1	1966.97	55.5%
Cigna	64643	professional	15	105.67	203.02	265.02	170.7%
Aetna	95700	professional	15	227.1	241.49	272.99	—%
UnitedHealthcare	95700	professional	15	192.44	259.49	427.15	—%
Cigna	95811	professional	15	288.69	729.45	953.66	114.7%
UnitedHealthcare	95812	professional	15	126.68	302.55	469.38	100.7%
Aetna	95908	professional	15	60.27	86.14	113.84	117.1%
Cigna	95923	professional	15	94	150.68	230.43	156.2%
UnitedHealthcare	95923	professional	15	74.43	140.55	231.48	138.6%
Cigna	96136	professional	15	38.72	41.86	59.05	85.8%
UnitedHealthcare	96136	professional	15	35.69	44.44	70.23	91.1%
Cigna	96139	professional	15	43.19	47.31	59.67	118.1%
Cigna	36224	professional	14	1312.17	2481.5	3696.49	80.7%
Cigna	36226	professional	14	1224.43	1424.74	3594.63	54.1%
Aetna	61624	professional	14	100.3	200.59	752.22	7.9%
Aetna	64483	professional	14	26.04	41	124.84	34.8%
Cigna	95719	professional	14	246.52	367.26	460.62	208%
UnitedHealthcare	95719	professional	14	341.29	501.94	589.53	283.1%
Aetna	95810	professional	14	175.65	654.47	954.89	112%
Aetna	95811	professional	14	194.51	721.84	1056.52	115.2%
UnitedHealthcare	95811	professional	14	404.51	720.66	1057.67	121.8%
UnitedHealthcare	95870	professional	14	57.06	100.46	153.7	157%
Aetna	96136	professional	14	17.09	44.43	52.77	102.6%
Aetna	99497	professional	14	67.24	83.89	101.42	93%
Aetna	64400	professional	13	13.83	41	63.47	93%
Aetna	64493	professional	13	97.05	114.08	129.39	26.7%
Aetna	92540	professional	13	30.04	82.15	106.62	94.9%
Cigna	92540	professional	13	58.05	109.44	157.76	127.5%
UnitedHealthcare	92540	professional	13	62.87	102.15	166.26	118.8%
Aetna	95812	professional	13	81.45	343.77	462.25	96.5%
Aetna	96365	professional	13	73.81	87.71	111.74	112.8%
Cigna	96365	professional	13	86.29	140.01	177.75	179.2%
Aetna	20526	professional	12	9.11	30.37	45.54	116.7%
Aetna	20610	professional	12	8.96	29.85	44.76	153.3%
Aetna	20611	professional	12	10.88	34.62	54.39	113.1%
Aetna	62323	professional	12	24.93	79.3	124.62	42.9%
Aetna	63650	professional	12	42.54	124.54	268.35	7.6%
Aetna	63685	professional	12	47.18	117.31	254.61	1.3%
Aetna	64640	professional	12	36.4	86.05	134.22	92.4%
Aetna	64647	professional	12	21.33	71.11	106.66	136.2%
Aetna	92546	professional	12	19.02	82.57	117.58	79.3%
Cigna	92546	professional	12	29.58	121.19	202.82	115.1%
UnitedHealthcare	92546	professional	12	27.99	83.19	160.62	92.1%
Cigna	95812	professional	12	137.23	226.54	575.49	110.6%
UnitedHealthcare	96139	professional	12	29.96	36.88	52.49	92.3%
UnitedHealthcare	96365	professional	12	100.82	121.3	196.43	156.1%
Aetna	20606	professional	11	9.35	29.8	46.73	107.9%
Aetna	22612	professional	11	144.02	463	1026.15	10.7%
Aetna	61626	professional	11	79.18	158.37	593.87	11.5%
Aetna	62321	professional	11	25.87	82.3	129.34	44.5%
Aetna	63045	professional	11	113.73	364.66	810.31	30.8%
Aetna	64418	professional	11	15.07	41	75.32	198.1%
Aetna	64479	professional	11	28.46	41	142.3	39.1%
Aetna	64490	professional	11	110.42	129.95	147.22	30.3%
Aetna	64633	professional	11	47.91	159.69	239.54	33.7%
Aetna	64635	professional	11	47.04	156.78	235.17	33.1%
Aetna	64646	professional	11	18.47	58.94	92.31	128.2%

Median rate by payer, percent of Medicare

Solid line 100% of Medicare.

How this is measured

Rates come from each payer's published Transparency in Coverage machine-readable file, filtered to this specialty's codes and to NPIs the CMS Medicare utilization file shows billing that code. Percentiles are computed per payer, code and site of service across those NPIs, then divided by the locality-adjusted Medicare amount for the same code and place. Full methodology.

Payer files: 2026-09

Questions

Is this what the practice was paid?

No. These are contracted rates as published by the payer, not allowed or paid amounts.

Why are some cells blank?

Ghost rates are removed using Medicare utilization. A row appears only if that NPI billed the code.

What is an episode total?

Professional plus facility when both exist. We never average them or invent a total from one side.

Saran Siva

Co-founder & CTO, Insight Health · September 2026 files