What do payers pay neurology groups in TX?

Across 618 NPIs, the median published rate is 90.7% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 67 procedure codes and 3 payers, the median published rate is 116 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 129 percent and Aetna the lowest at 99 percent, a spread of 30 points on identical work. 2 of 3 payers sit at or above Medicare and 1 below it. The best-covered row rests on 618 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 TX?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
UnitedHealthcare	99214	professional	618	105	128.34	147.01	90.7%
Cigna	99214	professional	615	108.11	126.47	162.23	94.9%
Aetna	99214	professional	583	44.01	96.56	118.92	76.4%
UnitedHealthcare	99215	professional	527	145.1	172.7	199.39	89%
Cigna	99215	professional	524	155.68	186.3	231.5	97.4%
Aetna	99215	professional	494	44	132.68	169.14	75.8%
UnitedHealthcare	99205	professional	424	209.6	244.33	299.29	104.2%
Cigna	99205	professional	423	200.3	253.9	310.34	109.1%
Aetna	99205	professional	400	46.68	176.92	240.02	82.7%
Cigna	99204	professional	371	143.99	190.75	220.67	108.4%
UnitedHealthcare	99204	professional	371	157.07	183.85	208.28	103.2%
Cigna	99213	professional	369	75.21	86.18	107.5	92.8%
UnitedHealthcare	99213	professional	367	73.73	86.54	108.61	86.7%
Aetna	99204	professional	348	46.68	135.78	171.61	83.3%
Aetna	99213	professional	345	42	68.42	81.82	74.7%
Cigna	95886	professional	272	57.52	70.19	115.83	129.2%
UnitedHealthcare	95886	professional	266	54.57	76.17	104.21	123.1%
UnitedHealthcare	95816	professional	256	98.04	363.35	470.23	124.4%
Cigna	95816	professional	255	90.24	409.56	510.05	130%
Aetna	95886	professional	249	43.35	54.52	85.05	100.2%
Aetna	95816	professional	238	71.52	273.92	384.3	101.2%
Cigna	95819	professional	165	89.35	447.14	578.43	128%
UnitedHealthcare	95819	professional	165	93.1	400.92	544.99	112.5%
Aetna	95819	professional	159	77.31	342.11	431.64	96.5%
Cigna	95910	professional	130	112.04	147.91	228.62	131.4%
UnitedHealthcare	95911	professional	130	138.14	178.82	257.64	135.2%
UnitedHealthcare	95910	professional	128	115.89	154.87	225.75	134.2%
Cigna	95911	professional	128	131.65	180.23	275.65	132.3%
Aetna	95911	professional	118	96.44	119.42	198.07	102.4%
Aetna	95910	professional	113	80.45	103.14	164.94	103.8%
Cigna	95720	professional	102	267.52	290.96	339.91	134.5%
UnitedHealthcare	95720	professional	101	255.94	322.82	374.54	149.2%
Aetna	95720	professional	94	94.17	205.02	265.26	113.4%
Cigna	95913	professional	92	180.73	255.38	371.86	134.8%
UnitedHealthcare	95913	professional	92	176.18	240.79	355.31	131.6%
Aetna	95913	professional	85	114.76	168.93	266.75	96.5%
Cigna	95885	professional	79	30.4	57.46	80.62	131.8%
UnitedHealthcare	95885	professional	79	29.5	54.23	75.35	129.4%
Cigna	95909	professional	77	86.06	112.63	174.14	128.7%
Aetna	95885	professional	75	21.89	45.67	61.79	104.7%
Cigna	95912	professional	75	148.04	211.3	322.2	132.6%
Aetna	95909	professional	74	60.24	78.35	125.92	105.1%
Cigna	99203	professional	74	92.7	114.51	135.42	99.4%
UnitedHealthcare	99203	professional	74	107.28	122.65	141.99	96.5%
UnitedHealthcare	95909	professional	73	86.48	115.91	165.64	125.7%
UnitedHealthcare	95912	professional	73	159.27	219.18	310.53	132.3%
Aetna	95912	professional	67	102.37	142.35	230.57	96.1%
Aetna	99203	professional	65	44	91.06	106.38	80%
Cigna	64615	professional	60	152.41	177.04	238.47	114.5%
UnitedHealthcare	64615	professional	60	161.9	212.71	290.99	142.7%
Aetna	64615	professional	54	31.41	98.59	139.87	94.7%
Cigna	96138	professional	54	41.38	41.38	45.68	115.6%
UnitedHealthcare	96138	professional	54	40.55	45.05	60	114.4%
Cigna	95822	professional	50	95.13	436.58	530.54	129.7%
Cigna	96132	professional	50	130.14	140.53	149.68	116.8%
UnitedHealthcare	96132	professional	50	126.75	131.37	150.24	108%
UnitedHealthcare	95718	professional	49	187.09	229.54	248.17	163.1%
Aetna	96138	professional	49	33.13	40.56	42.53	92.5%
Cigna	64616	professional	48	139.35	169.16	194.53	119.4%
Cigna	95718	professional	48	178.97	217.97	258.86	154.9%
UnitedHealthcare	95822	professional	48	96.01	383.78	539.67	129.3%
Aetna	96132	professional	47	108.67	138.62	145.35	107.8%
UnitedHealthcare	64616	professional	46	145.18	187.02	220.19	131.9%
Aetna	64616	professional	45	33.51	93.66	124.91	91%
Aetna	95718	professional	45	60.92	122.56	185.11	113.4%
Aetna	95822	professional	45	77.23	283.67	490.67	119.7%
UnitedHealthcare	95813	professional	42	157.88	351.68	504.87	118.8%
Cigna	95983	professional	42	66.77	70.49	82.07	134.6%
Cigna	95813	professional	41	151.54	433.37	579.18	126.4%
Cigna	95938	professional	41	76.81	404.67	499.36	131.3%
UnitedHealthcare	95983	professional	41	62.3	76.51	91.95	148.9%
Aetna	95813	professional	38	116.55	332.49	492.15	108.2%
UnitedHealthcare	95700	professional	37	249.38	278.42	307.99	—%
Cigna	95861	professional	37	103.16	130.38	219.97	141.6%
Cigna	99483	professional	37	223.54	223.54	294.8	78.7%
UnitedHealthcare	99483	professional	37	219.39	241.64	276.55	83.4%
Aetna	95983	professional	35	37.91	50.49	63.52	113.6%
Cigna	95939	professional	34	200.17	576.72	736.73	133.7%
UnitedHealthcare	93880	professional	33	49.62	195.18	242.2	130.1%
UnitedHealthcare	95861	professional	33	98.29	143.98	193.34	148.7%
UnitedHealthcare	95938	professional	33	78.91	345.5	507.79	128.1%
Aetna	99483	professional	33	193.67	228.25	250.58	71.1%
Cigna	93880	professional	32	50.06	184.07	228.89	126.8%
Aetna	95938	professional	32	58.2	198.8	311.22	89.5%
Cigna	70551	professional	31	73.05	139.64	212.69	110%
UnitedHealthcare	70551	professional	31	113.33	234.69	343.99	178.7%
UnitedHealthcare	93886	professional	31	57.04	263.54	301.92	124.1%
Cigna	95700	professional	31	293.85	334.82	334.82	—%
Cigna	95874	professional	31	33.73	74.52	99.36	129.2%
Cigna	64405	professional	30	70.71	71.71	90.29	93%
Aetna	93880	professional	30	35.32	139.56	169.66	95.6%
Cigna	93886	professional	30	55.6	276.19	330.78	124.6%
Aetna	64405	professional	29	13.31	43.25	64.98	94.4%
UnitedHealthcare	64405	professional	29	81.16	110.85	176.7	195.3%
Aetna	95700	professional	29	115.62	189.81	213.53	—%
Cigna	95715	professional	29	1055.01	1159.1	1159.1	—%
UnitedHealthcare	95715	professional	29	881.54	986.98	1113.26	—%
Cigna	95908	professional	29	72.6	99.78	144.77	128.5%
UnitedHealthcare	96365	professional	29	75.79	83.4	85.64	128.3%
Aetna	70551	professional	28	55.44	171.72	235.8	140.7%
Aetna	93886	professional	28	50.07	167.29	208.95	82.5%
Aetna	95861	professional	28	63.76	78.26	127.52	96.5%
UnitedHealthcare	95874	professional	28	35	76.46	108.65	141.3%
Cigna	95923	professional	28	67.96	113.19	159.37	136.8%
Cigna	96365	professional	28	73.88	75.45	91.33	116%
Cigna	99212	professional	28	44.09	50.36	67.66	84.6%
UnitedHealthcare	99212	professional	28	48.99	51.98	55.2	86.8%
Aetna	95874	professional	27	28.07	59.91	82.59	107%
UnitedHealthcare	95923	professional	27	70.74	115.5	158.66	126.2%
UnitedHealthcare	95939	professional	27	204.75	526.05	702.26	128.8%
Cigna	64612	professional	26	143.14	179.03	230.65	134.6%
UnitedHealthcare	64612	professional	26	151.44	192.67	219.55	142.7%
Aetna	96365	professional	26	62.64	64.83	76.79	102.4%
Aetna	64612	professional	25	42	71.8	127.31	125.8%
Cigna	95812	professional	25	91.85	375.59	472.94	127%
Aetna	95923	professional	25	60.99	97.84	156.67	121.7%
Aetna	95939	professional	25	113.69	275.37	425.99	89.6%
Cigna	95984	professional	25	55.91	61.05	68.96	134.7%
Aetna	99212	professional	25	40.43	42.82	54.36	73.4%
Cigna	70553	professional	24	112.76	232.51	345.27	109.8%
UnitedHealthcare	70553	professional	24	175.62	444.77	548.46	180.5%
Aetna	95715	professional	24	396.92	629.69	670.02	—%
UnitedHealthcare	95810	professional	24	202.21	598.67	808.37	127%
Cigna	95870	professional	24	39.17	83.65	125.87	143.7%
UnitedHealthcare	95908	professional	24	69.69	84.65	131.92	122.4%
UnitedHealthcare	95984	professional	24	52.03	67.48	78.45	146.5%
Aetna	70553	professional	23	87.06	220.08	374.64	123.1%
Cigna	95810	professional	23	201.44	663.7	814.84	126.7%
Aetna	95812	professional	23	63.65	266.89	337.22	97.8%
UnitedHealthcare	95812	professional	23	98.04	347.29	457.27	133%
Aetna	95908	professional	22	48.57	62.01	104.84	105.3%
Cigna	95970	professional	22	26.05	38.5	51.14	200%
Aetna	95810	professional	21	136.15	485.39	648.89	112.6%
UnitedHealthcare	95870	professional	21	36.02	75.14	112.25	118.2%
UnitedHealthcare	95970	professional	21	23.14	30.04	39.55	156%
Aetna	95984	professional	21	39.94	46	54.9	107.4%
Aetna	93040	professional	20	4.55	8.54	11.32	75%
Cigna	93040	professional	20	15.79	16	16.87	109.5%
UnitedHealthcare	93040	professional	20	12.99	13.62	14.13	91.4%
Cigna	96139	professional	20	42.59	45.23	62.6	131.3%
UnitedHealthcare	96139	professional	20	45.63	46.49	76.24	136.4%
UnitedHealthcare	96366	professional	20	22.4	23.03	26.51	110.2%
Cigna	95800	professional	19	73.28	127.13	182.85	132.6%
Cigna	95811	professional	19	209.87	694.58	851.78	126.8%
UnitedHealthcare	95811	professional	19	213.99	630.77	860.76	133.4%
Aetna	95870	professional	19	19.01	46.77	67.13	95.9%
Aetna	20553	professional	18	13.29	43.25	48.05	99.8%
Aetna	95970	professional	18	17.08	25.6	43.44	105.2%
Aetna	96366	professional	18	19.3	20.81	23.54	99.3%
Cigna	96366	professional	18	23.86	24.51	28.74	117.4%
Cigna	20553	professional	17	57.82	58.32	72.41	119.2%
UnitedHealthcare	20553	professional	17	60.94	64.44	80.66	111.4%
Aetna	64642	professional	17	26.02	87.25	130.86	116.2%
Cigna	64642	professional	17	167.49	182.96	221.56	122.1%
UnitedHealthcare	95800	professional	17	77.76	177.35	232.86	176.9%
Cigna	96372	professional	17	17.27	17.27	18.92	116.3%
UnitedHealthcare	96372	professional	17	18.08	25.42	29.48	171.9%
Aetna	64450	professional	16	11.91	42.63	59.52	88.5%
UnitedHealthcare	64642	professional	16	183.92	201.96	223.15	132.7%
Aetna	95800	professional	16	63.07	132.41	161.76	124.5%
Aetna	95811	professional	16	142.41	507.94	683.08	101.6%
Aetna	96139	professional	16	31.96	42.53	70.42	98.6%
Aetna	96372	professional	16	17.38	20.63	25.01	136.2%
Cigna	99490	professional	15	51.6	54.06	55.09	81.9%
UnitedHealthcare	99490	professional	15	42.68	43.16	48.11	67%
Cigna	36226	professional	14	1559.39	1839.58	2238	82.4%
UnitedHealthcare	36226	professional	14	1493.82	1720.08	1901.02	77%
Cigna	64450	professional	14	64.98	64.98	76.56	83.5%
UnitedHealthcare	64450	professional	14	68.7	97.79	134.59	127.3%
Cigna	96413	professional	14	154.45	186.84	194.19	144.4%
Aetna	99490	professional	14	42.83	44.68	60.65	67.7%
Cigna	36224	professional	13	1537.34	1864.47	2326.23	78.9%
UnitedHealthcare	36224	professional	13	1679.23	1807.91	2046.47	78.3%
Aetna	64445	professional	13	42.81	51.05	94.99	57%
Aetna	64447	professional	13	40.6	45.78	73.13	56.5%
Cigna	72141	professional	13	73.05	133.66	206.71	109%
UnitedHealthcare	72141	professional	13	113.87	224.49	264.62	167.2%
Cigna	95724	professional	13	347.25	388.32	407.91	118%
UnitedHealthcare	95724	professional	13	334.55	350.79	368.01	107.4%
Cigna	95868	professional	13	88.93	126.57	183.85	149.4%
UnitedHealthcare	96413	professional	13	160.96	177.19	205.56	132.9%
Aetna	72141	professional	12	57.91	128.07	218.5	128.8%
Aetna	72148	professional	12	55.82	130	207.96	127.1%
Cigna	72148	professional	12	73.4	134.01	207.41	109.1%
UnitedHealthcare	72148	professional	12	111.32	196.83	265.05	150%
Aetna	95724	professional	12	298.04	331.2	377.19	110.8%
Aetna	96413	professional	12	118.19	125.96	174.48	99.3%
Cigna	96415	professional	12	33.04	39.73	41.25	144.2%
Cigna	36223	professional	11	1324.45	1575.73	1961.48	86.4%
UnitedHealthcare	36223	professional	11	1177.58	1525.29	1803.01	88.6%
Aetna	36224	professional	11	678.62	1410.8	1667.09	67.2%
Aetna	36226	professional	11	688.27	1366.41	1616.48	67.4%
Cigna	61645	professional	11	1258.86	1508.66	1768.27	203.9%
UnitedHealthcare	61645	professional	11	1226.92	1346.36	1557.01	172.2%
Cigna	64445	professional	11	127.9	127.9	127.9	76.8%
UnitedHealthcare	64445	professional	11	178.39	223.69	223.69	129.6%
Cigna	64447	professional	11	94.7	99.2	99.2	76.6%
UnitedHealthcare	64447	professional	11	127.89	199.63	199.63	149.3%
UnitedHealthcare	95868	professional	11	78.93	133.13	189.29	163.2%
Aetna	95924	professional	11	77.55	120.77	250.51	107.7%

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