What do payers pay neurosurgery groups in TX?
Across 249 NPIs, the median published rate is 97.2% of locality-adjusted Medicare (September 2026 files).
Data as of the September 2026 payer files.
Across 71 procedure codes and 3 payers, the median published rate is 124 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 157 percent and Aetna the lowest at 106 percent, a spread of 51 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 249 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
| Payer | Code | Site | n | p25 | p50 | p75 | % of Medicare |
|---|---|---|---|---|---|---|---|
| UnitedHealthcare | 99214 | professional | 249 | 114.09 | 129.98 | 157.14 | 97.2% |
| Aetna | 99214 | professional | 245 | 50 | 104.76 | 154.65 | 84% |
| Cigna | 99214 | professional | 245 | 111.9 | 137.35 | 159.59 | 101.5% |
| UnitedHealthcare | 99204 | professional | 239 | 167.18 | 202.77 | 260.59 | 118.3% |
| Aetna | 99204 | professional | 237 | 58.03 | 159.29 | 248.34 | 91.7% |
| Cigna | 99204 | professional | 237 | 164.59 | 211.36 | 246.54 | 118.4% |
| UnitedHealthcare | 99213 | professional | 226 | 78.94 | 88.24 | 112.87 | 93.2% |
| Cigna | 99213 | professional | 221 | 76.02 | 92.27 | 111.56 | 97.7% |
| Aetna | 99213 | professional | 219 | 48 | 71.99 | 106.78 | 82.2% |
| Aetna | 99203 | professional | 128 | 47.49 | 98.43 | 159.94 | 88.2% |
| UnitedHealthcare | 99203 | professional | 127 | 118.76 | 135.16 | 163.91 | 118.2% |
| Cigna | 99203 | professional | 124 | 108.86 | 132.79 | 170.05 | 114.5% |
| UnitedHealthcare | 22853 | professional | 121 | 341.12 | 419.9 | 495.02 | 186.1% |
| Cigna | 22853 | professional | 118 | 321.14 | 385.18 | 480.61 | 172.6% |
| Aetna | 22853 | professional | 109 | 58.51 | 222.34 | 303.89 | 129.4% |
| UnitedHealthcare | 63047 | professional | 103 | 1424.06 | 1843.18 | 2098.75 | 173.2% |
| Cigna | 63047 | professional | 100 | 1490.46 | 1640.26 | 1922.79 | 159.1% |
| Aetna | 63047 | professional | 99 | 114.19 | 667.91 | 1240.76 | 119.7% |
| Cigna | 99215 | professional | 87 | 156.66 | 188.28 | 231.5 | 99.5% |
| UnitedHealthcare | 99215 | professional | 85 | 152.1 | 178.78 | 230.18 | 92.8% |
| UnitedHealthcare | 63048 | professional | 82 | 274.49 | 355.97 | 403.3 | 186% |
| Aetna | 99215 | professional | 82 | 54.92 | 142.3 | 201.72 | 84.2% |
| UnitedHealthcare | 22614 | professional | 81 | 503.76 | 609.9 | 750.76 | 175.2% |
| Cigna | 22614 | professional | 79 | 474.1 | 582.98 | 685.44 | 168.1% |
| Cigna | 63048 | professional | 79 | 281.05 | 314.04 | 376.7 | 172.6% |
| Aetna | 22614 | professional | 76 | 139.61 | 357.01 | 472.42 | 132% |
| UnitedHealthcare | 22842 | professional | 76 | 1004.27 | 1194.77 | 1461.46 | 170.6% |
| Aetna | 63048 | professional | 76 | 51.11 | 172.43 | 247.21 | 128.3% |
| Cigna | 99205 | professional | 76 | 231.09 | 265.36 | 324.58 | 113.6% |
| UnitedHealthcare | 99205 | professional | 75 | 235.77 | 265.42 | 340.58 | 113.6% |
| Cigna | 22842 | professional | 74 | 950.9 | 1139.47 | 1347.5 | 172.2% |
| Aetna | 99205 | professional | 74 | 61.87 | 204.67 | 309.34 | 89.9% |
| Aetna | 22842 | professional | 68 | 91.5 | 460.29 | 866.63 | 129.5% |
| UnitedHealthcare | 22551 | professional | 55 | 2176.75 | 2863.26 | 3257.68 | 184.5% |
| Cigna | 22612 | professional | 54 | 1926.8 | 2189.56 | 2657.71 | 154.1% |
| UnitedHealthcare | 22612 | professional | 54 | 2018.77 | 2400.54 | 2916.83 | 163.8% |
| Cigna | 61783 | professional | 54 | 326.29 | 388.72 | 411.45 | 173.1% |
| Aetna | 22551 | professional | 53 | 1377.56 | 1822.17 | 2502.55 | 117% |
| Cigna | 22551 | professional | 53 | 2064.34 | 2497.93 | 3204.9 | 157.7% |
| Aetna | 22612 | professional | 53 | 189.69 | 906.55 | 1701.22 | 119.5% |
| UnitedHealthcare | 61783 | professional | 53 | 341.56 | 399.77 | 444.76 | 184.4% |
| Cigna | 99212 | professional | 47 | 45.57 | 51.98 | 68.62 | 86.5% |
| UnitedHealthcare | 99212 | professional | 47 | 45.32 | 54.01 | 66.27 | 89.8% |
| Aetna | 61783 | professional | 46 | 218.87 | 255.03 | 336.95 | 126.8% |
| Aetna | 99212 | professional | 46 | 42.22 | 47.52 | 57.48 | 82% |
| Cigna | 22840 | professional | 44 | 950.95 | 1114.93 | 1303.64 | 171.8% |
| Cigna | 22633 | professional | 43 | 2067.63 | 2753.16 | 3181.25 | 166.2% |
| UnitedHealthcare | 22633 | professional | 43 | 2423.53 | 2979.77 | 3537.81 | 178.5% |
| Aetna | 22840 | professional | 42 | 82.21 | 455.59 | 757.15 | 115.5% |
| UnitedHealthcare | 22840 | professional | 41 | 1042.29 | 1279.86 | 1452.68 | 187.4% |
| Aetna | 22633 | professional | 37 | 718.62 | 1501.6 | 2058.12 | 120.7% |
| Aetna | 22845 | professional | 36 | 87.08 | 383.46 | 744.79 | 118.8% |
| Cigna | 22845 | professional | 35 | 919.07 | 1045.05 | 1338.06 | 166.3% |
| UnitedHealthcare | 22845 | professional | 35 | 966.33 | 1152.54 | 1342.38 | 183.4% |
| Cigna | 63052 | professional | 35 | 286.89 | 390.11 | 440.48 | 167.1% |
| UnitedHealthcare | 63052 | professional | 35 | 343.53 | 425.85 | 501.61 | 187.1% |
| Aetna | 63052 | professional | 29 | 42.28 | 158.54 | 263.98 | 113.8% |
| Cigna | 61781 | professional | 28 | 378.29 | 455.86 | 539.29 | 194.5% |
| Cigna | 22552 | professional | 24 | 440.85 | 541.52 | 593.81 | 145% |
| UnitedHealthcare | 61781 | professional | 24 | 343.05 | 428.13 | 632.71 | 193.4% |
| Aetna | 22552 | professional | 23 | 200.04 | 366.81 | 437.65 | 112.7% |
| UnitedHealthcare | 22552 | professional | 23 | 458.51 | 556.28 | 743.9 | 159.1% |
| Aetna | 22558 | professional | 22 | 237.08 | 957.5 | 1659.27 | 115.5% |
| Cigna | 72110 | professional | 22 | 18.47 | 34.48 | 45.97 | 91.4% |
| UnitedHealthcare | 72110 | professional | 22 | 20.06 | 41.79 | 55.92 | 113.3% |
| Cigna | 22558 | professional | 21 | 1834.34 | 2073.61 | 2543.5 | 137.5% |
| UnitedHealthcare | 22558 | professional | 21 | 1738.95 | 2129.09 | 2705.17 | 153.6% |
| Cigna | 36224 | professional | 21 | 659.88 | 1653.85 | 1797.56 | 70% |
| UnitedHealthcare | 36224 | professional | 21 | 1595.77 | 1781.08 | 2237.7 | 78.3% |
| Aetna | 72100 | professional | 21 | 14.19 | 30.46 | 42.57 | 106.1% |
| Cigna | 72100 | professional | 21 | 13.77 | 25.33 | 34.54 | 89.8% |
| UnitedHealthcare | 72100 | professional | 21 | 15.15 | 29.88 | 40.23 | 109.5% |
| Aetna | 72110 | professional | 21 | 16.73 | 40.76 | 51.32 | 105.4% |
| Cigna | 20939 | professional | 19 | 77.3 | 87.26 | 107.84 | 145.1% |
| UnitedHealthcare | 20939 | professional | 19 | 86.88 | 91.58 | 110.74 | 153.3% |
| Cigna | 36226 | professional | 19 | 631.96 | 1553.48 | 1706.7 | 68.5% |
| UnitedHealthcare | 36226 | professional | 19 | 1455.81 | 1676.44 | 1955.44 | 74.9% |
| Aetna | 61781 | professional | 19 | 264.32 | 337.33 | 732.88 | 132.3% |
| Aetna | 72040 | professional | 19 | 14.63 | 29.84 | 41.95 | 104.3% |
| Cigna | 72040 | professional | 19 | 14.17 | 25.04 | 34.65 | 90.6% |
| UnitedHealthcare | 72040 | professional | 19 | 17.83 | 28.4 | 40.23 | 107.7% |
| Aetna | 36224 | professional | 18 | 839.21 | 1441.22 | 1682.54 | 69% |
| Cigna | 61886 | professional | 18 | 1175.09 | 1289.76 | 1581.51 | 141.9% |
| Cigna | 69990 | professional | 18 | 296.48 | 363.98 | 519.51 | 179.1% |
| UnitedHealthcare | 69990 | professional | 18 | 315.86 | 398.36 | 526.97 | 196.1% |
| Cigna | 36223 | professional | 17 | 606.48 | 1291.07 | 1470.47 | 67.8% |
| UnitedHealthcare | 36223 | professional | 17 | 1179.69 | 1392.31 | 1645.07 | 78.3% |
| Aetna | 36223 | professional | 16 | 1013.85 | 1171.95 | 1363.7 | 71.7% |
| Aetna | 36226 | professional | 16 | 1148.34 | 1395.95 | 1593.58 | 69.1% |
| UnitedHealthcare | 61886 | professional | 16 | 1217.95 | 1502.45 | 1565.57 | 153.6% |
| Cigna | 63053 | professional | 16 | 249.99 | 301.29 | 348.67 | 151.6% |
| UnitedHealthcare | 63053 | professional | 16 | 279.89 | 361.43 | 386.95 | 178.2% |
| UnitedHealthcare | 63685 | professional | 16 | 411.68 | 506.27 | 734.38 | 158.9% |
| Aetna | 69990 | professional | 16 | 215.61 | 310.27 | 432.29 | 145.6% |
| Aetna | 61886 | professional | 15 | 131.16 | 941.97 | 1284.69 | 128.5% |
| Cigna | 63685 | professional | 15 | 388.2 | 439.65 | 564.2 | 136.7% |
| Aetna | 20939 | professional | 14 | 11.18 | 48.6 | 76.67 | 124.9% |
| Cigna | 22514 | professional | 14 | 1067 | 3286.64 | 4481.98 | 61.7% |
| UnitedHealthcare | 22514 | professional | 14 | 4618.13 | 5702.23 | 7260.13 | 104.1% |
| Aetna | 61624 | professional | 14 | 185 | 1111.5 | 1739.66 | 128.5% |
| Cigna | 61624 | professional | 14 | 1675.6 | 1716.05 | 1839.25 | 167.6% |
| UnitedHealthcare | 61624 | professional | 14 | 1682.02 | 2041.76 | 2420.04 | 208.7% |
| Aetna | 63685 | professional | 14 | 52.79 | 323.67 | 391.55 | 113.3% |
| Cigna | 22634 | professional | 13 | 540.81 | 753.77 | 887.52 | 179.6% |
| UnitedHealthcare | 22634 | professional | 13 | 652.31 | 913.73 | 962.09 | 213.3% |
| Aetna | 63053 | professional | 13 | 28.76 | 85.59 | 183.58 | 104.5% |
| Aetna | 22585 | professional | 12 | 85.12 | 310.69 | 374.8 | 119.6% |
| Cigna | 22585 | professional | 12 | 439.83 | 466.08 | 558.42 | 166.7% |
| UnitedHealthcare | 22585 | professional | 12 | 404.23 | 458.69 | 579.54 | 161.8% |
| Aetna | 22634 | professional | 12 | 152.89 | 447.13 | 708.28 | 167.1% |
| Cigna | 22846 | professional | 12 | 838.39 | 1050.29 | 1157.25 | 160.8% |
| UnitedHealthcare | 22846 | professional | 12 | 997.84 | 1061.01 | 1449.65 | 160.2% |
| Cigna | 61796 | professional | 12 | 1512.77 | 1597.48 | 2552.51 | 147.2% |
| Aetna | 20931 | professional | 10 | 20.97 | 89.99 | 121.32 | 122.5% |
| UnitedHealthcare | 20931 | professional | 10 | 135.02 | 168.53 | 212.7 | 167.9% |
| Aetna | 22514 | professional | 10 | 631.84 | 1936.4 | 2892.19 | 57.9% |
| Aetna | 22600 | professional | 10 | 361.44 | 1493.58 | 1902.14 | 115.8% |
| Cigna | 22600 | professional | 10 | 1580.8 | 1702.79 | 2006.42 | 132.2% |
| UnitedHealthcare | 22600 | professional | 10 | 1628.09 | 1776.69 | 2538.45 | 142.6% |
| Aetna | 22846 | professional | 10 | 73.21 | 367.82 | 749.77 | 121.6% |
| Cigna | 61797 | professional | 10 | 388.32 | 413.71 | 653.41 | 189.3% |
| Aetna | 72070 | professional | 10 | 13.8 | 24.19 | 34.47 | 96.6% |
| Cigna | 72070 | professional | 10 | 13.01 | 20.19 | 28.49 | 91.1% |
| UnitedHealthcare | 72070 | professional | 10 | 12.73 | 22.57 | 33.31 | 109.3% |
| Cigna | 20931 | professional | 9 | 123.66 | 155.84 | 170.93 | 147.1% |
| Cigna | 20937 | professional | 9 | 185.14 | 185.14 | 241.14 | 129.3% |
| UnitedHealthcare | 20937 | professional | 9 | 201.28 | 234.61 | 285.38 | 162.6% |
| Aetna | 22513 | professional | 9 | 660.97 | 1991.31 | 3112.31 | 57% |
| Cigna | 22513 | professional | 9 | 1146.06 | 3148.04 | 3468.85 | 57.1% |
| UnitedHealthcare | 22513 | professional | 9 | 4600.98 | 7266.61 | 7344.63 | 131.7% |
| Cigna | 61645 | professional | 9 | 1242.65 | 1263.65 | 1472.19 | 171.8% |
| UnitedHealthcare | 61645 | professional | 9 | 1300.03 | 1591.5 | 1965.58 | 216.4% |
| Aetna | 64493 | professional | 9 | 128.55 | 135.98 | 167.64 | 74.3% |
| Cigna | 61510 | professional | 8 | 3524.65 | 3737.7 | 3772.52 | 160.9% |
| UnitedHealthcare | 61510 | professional | 8 | 3924.12 | 5746.58 | 5746.58 | 247.4% |
| UnitedHealthcare | 63650 | professional | 8 | 1163.24 | 1372.44 | 2431.21 | 60.3% |
| Cigna | 63655 | professional | 8 | 935.78 | 973.55 | 1115.71 | 116.9% |
| UnitedHealthcare | 63655 | professional | 8 | 947.85 | 1018.15 | 1312.3 | 124.8% |
| Aetna | 64483 | professional | 8 | 52.09 | 180.14 | 273.91 | 75.6% |
| Cigna | 64493 | professional | 8 | 154.93 | 198.19 | 264.39 | 108.4% |
| UnitedHealthcare | 64493 | professional | 8 | 151.32 | 167.26 | 200.82 | 91.4% |
| Aetna | 99202 | professional | 8 | 69.68 | 109.48 | 213.88 | 102% |
| Cigna | 99202 | professional | 8 | 90.67 | 112.16 | 129.76 | 146.4% |
| UnitedHealthcare | 99202 | professional | 8 | 111.67 | 117.57 | 131.54 | 156.9% |
| Aetna | 20937 | professional | 7 | 21.76 | 67.21 | 125.61 | 119.6% |
| Aetna | 22843 | professional | 7 | 138.65 | 605.51 | 1050.48 | 131.1% |
| Cigna | 22843 | professional | 7 | 1281.65 | 1361.68 | 1586.96 | 173.4% |
| UnitedHealthcare | 22843 | professional | 7 | 1284.61 | 1444.29 | 1626.06 | 187.3% |
| Aetna | 61510 | professional | 7 | 63.18 | 2580.59 | 7743.75 | 333.4% |
| Aetna | 61645 | professional | 7 | 352.27 | 873.78 | 1216.99 | 149.7% |
| UnitedHealthcare | 61796 | professional | 7 | 1529.54 | 1790.67 | 3054.56 | 165% |
| Aetna | 62323 | professional | 7 | 182.87 | 218.8 | 1068.22 | 81% |
| Aetna | 63030 | professional | 7 | 109.91 | 490.04 | 890.51 | 98.8% |
| Aetna | 63045 | professional | 7 | 659.4 | 1286.72 | 2024.46 | 98% |
| Cigna | 63045 | professional | 7 | 1676.8 | 1849.17 | 2348.97 | 153.3% |
| UnitedHealthcare | 63045 | professional | 7 | 2118.26 | 2446.78 | 2583.35 | 202.9% |
| Aetna | 63650 | professional | 7 | 226.74 | 1195.53 | 1525.37 | 58.2% |
| Cigna | 63650 | professional | 7 | 684.69 | 1410.76 | 1531.18 | 30.1% |
| Aetna | 63655 | professional | 7 | 231.7 | 869.62 | 1162.97 | 96.4% |
| Cigna | 64483 | professional | 7 | 195.8 | 256.97 | 275.88 | 101.1% |
| UnitedHealthcare | 64483 | professional | 7 | 213.66 | 224.73 | 235.85 | 88.4% |
| Aetna | 64494 | professional | 7 | 65.81 | 69.68 | 75.03 | 75.3% |
| Cigna | 64494 | professional | 7 | 92.98 | 108.15 | 140.51 | 116.9% |
| UnitedHealthcare | 64494 | professional | 7 | 82.96 | 93.82 | 119.67 | 101.4% |
| Aetna | 72114 | professional | 7 | 20.13 | 44 | 50.31 | 86% |
| Cigna | 72114 | professional | 7 | 19.82 | 36.37 | 54.2 | 88.8% |
| UnitedHealthcare | 72114 | professional | 7 | 18.62 | 42.51 | 57.26 | 104.7% |
| Aetna | 95886 | professional | 7 | 43.35 | 52.35 | 95.75 | 100.2% |
| UnitedHealthcare | 95886 | professional | 7 | 51.97 | 70.16 | 96.38 | 111.3% |
| Aetna | 27096 | professional | 6 | 45.15 | 87.61 | 137.13 | 81.4% |
| Cigna | 27096 | professional | 6 | 154.81 | 204.16 | 208.51 | 119.2% |
| UnitedHealthcare | 27096 | professional | 6 | 161.33 | 189.45 | 224.7 | 112.2% |
| Aetna | 27279 | professional | 6 | 1103.91 | 1284.23 | 1746.06 | 127.7% |
| Aetna | 61796 | professional | 6 | 1573.29 | 2106.3 | 3009 | 225.7% |
| Aetna | 61797 | professional | 6 | 326.33 | 580.37 | 822.58 | 289.2% |
| UnitedHealthcare | 61797 | professional | 6 | 376.35 | 526.12 | 663.36 | 259.8% |
| Aetna | 61798 | professional | 6 | 1534.56 | 1888.6 | 2660.38 | 168.6% |
| Cigna | 61798 | professional | 6 | 2029.2 | 2549.79 | 3847.75 | 188.9% |
| UnitedHealthcare | 61798 | professional | 6 | 1957.22 | 2218.12 | 3727.64 | 159.9% |
| UnitedHealthcare | 62323 | professional | 6 | 195.83 | 218 | 307.04 | 83.2% |
| Cigna | 63030 | professional | 6 | 1029.89 | 1085.85 | 1200.63 | 121.9% |
| UnitedHealthcare | 63030 | professional | 6 | 1096.91 | 1193.16 | 1453.08 | 134.5% |
| Aetna | 64635 | professional | 6 | 312.85 | 319.82 | 1506.15 | 71.7% |
| Cigna | 95886 | professional | 6 | 51.54 | 72.62 | 96.82 | 114.7% |
| Cigna | 27279 | professional | 5 | 912.14 | 1032.21 | 1032.21 | 138.2% |
| UnitedHealthcare | 27279 | professional | 5 | 983.1 | 1076.28 | 1805.45 | 146.2% |
| Aetna | 27280 | professional | 5 | 240.18 | 928.69 | 1696.55 | 103.1% |
| Cigna | 27280 | professional | 5 | 1647.01 | 1700.76 | 1981.98 | 136.9% |
| UnitedHealthcare | 27280 | professional | 5 | 1591.22 | 2390.1 | 2587.41 | 190% |
| Cigna | 61800 | professional | 5 | 207.32 | 294.66 | 294.66 | 187.1% |
| Cigna | 61867 | professional | 5 | 3768.02 | 3795.88 | 4295.56 | 176.7% |
| UnitedHealthcare | 61867 | professional | 5 | 3673.77 | 4090.01 | 4288.15 | 192.9% |
| Aetna | 62272 | professional | 5 | 26.26 | 65.65 | 123.35 | 89.1% |
| Cigna | 62323 | professional | 5 | 192.31 | 209.59 | 296.4 | 80% |
| Aetna | 62350 | professional | 5 | 409.01 | 877.46 | 1722.05 | 97.2% |
| Aetna | 62362 | professional | 5 | 394.84 | 908.78 | 1741.91 | 95.3% |
| Aetna | 63056 | professional | 5 | 2000 | 2000 | 2008.18 | 110% |
| Aetna | 63267 | professional | 5 | 160.62 | 765.79 | 1338.51 | 64% |
| Cigna | 63267 | professional | 5 | 1733.58 | 1930.51 | 1997.26 | 151.2% |
| UnitedHealthcare | 63267 | professional | 5 | 1720.66 | 1805.45 | 2149.34 | 141.4% |
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