Insight Health

What do payers pay radiation-oncology groups in CO?

Across 70 NPIs, the median published rate is 161.3% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 22 procedure codes and 3 payers, the median published rate is 149 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 187 percent and Aetna the lowest at 130 percent, a spread of 57 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 70 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 radiation-oncology groups in CO?
PayerCodeSitenp25p50p75% of Medicare
Cigna77263professional70253.29276.61370.07161.3%
Cigna77300professional7052.466.99101.76159.1%
Cigna77427professional69288.31320.62426.52160.6%
UnitedHealthcare77300professional6861.2194.6120.63187.1%
UnitedHealthcare77263professional67274.66330.2491.34192.5%
Cigna77334professional67102.54140.78197.55153.6%
UnitedHealthcare77427professional67318.42373.03553.41186.9%
UnitedHealthcare77334professional65120.21177.02232.55203.6%
Cigna99205professional64288.66307.74378.04126.9%
Cigna77301professional62955.442250.053189.8153.5%
UnitedHealthcare99205professional62276.63356.91424.68147.2%
Cigna77338professional61378.56502.88728.94162.5%
UnitedHealthcare77301professional601219.72865.223887.98181.5%
UnitedHealthcare77338professional59425.16655.13837.21189.8%
Cigna77290professional51186.01576.96811.14165.9%
UnitedHealthcare77290professional49240.07723.691047.79195.6%
Aetna77263professional4887.88165.67224.96131.1%
Aetna77300professional4839.8551.3270.98130.8%
Cigna77280professional4789.09365.83470.7161.2%
Aetna77334professional4777.11101.9133.76131.1%
Aetna77427professional46100.29200.56256.72128.6%
UnitedHealthcare77280professional45108.86354.13535.41177.3%
Aetna99205professional4427.190.32184.8678.2%
Cigna77295professional42381.59496.07735.41160.8%
Aetna77301professional42658.711576.142462.39130.3%
UnitedHealthcare77295professional41441.6655.13868.83198.2%
Aetna77338professional41323.65401.5574.14130.8%
Cigna99213professional37113.25123.3148.66125.6%
Cigna99215professional37233.15252.69276.03127.7%
UnitedHealthcare99215professional37188.8248.91284.52125.8%
Cigna99214professional36163.09180.87220.4129.6%
UnitedHealthcare99213professional3595.09121.48130.97123.7%
UnitedHealthcare99214professional35162.6183.09201.42131.1%
Cigna77470professional3398.2161.62255.15166.3%
UnitedHealthcare77470professional3290.99212.75312.32191.9%
Aetna77290professional31123.66383.87599.39131.2%
UnitedHealthcare77332professional3164.4569.1791.89311.4%
Cigna77332professional3037.863.4125.5261.1%
Aetna99215professional2921.8388.87156.479%
Aetna77280professional2857.23228.87358.35128.4%
Aetna77295professional28279.25355.46513.4131%
Cigna77435professional28957.321015.121483.39155.4%
Aetna99214professional2815.2150.7107.7277.2%
UnitedHealthcare77435professional261066.111287.641867.73197%
Aetna99213professional2510.6250.7374.1175.5%
Aetna77470professional2153.36122.79162.69130%
UnitedHealthcare77293professional17308.23652.76990.82208.7%
Aetna77332professional1723.2431.8847.59130.3%
Aetna77435professional17670.76825.39858.57131.4%
Cigna77293professional16254.57424.72830.19171.6%
Cigna99204professional16229.08235.43299.81129.4%
Cigna77336professional1583.36129.74139.48143.2%
UnitedHealthcare77336professional14106.15111.54144.94114.5%
UnitedHealthcare99204professional14210.93273.07330.59150.1%
Aetna77293professional11145.56407.59548.09129.5%
Aetna99204professional1020.2667.54145.1475.9%
Cigna99212professional863.0468.3273.76111.1%
UnitedHealthcare99212professional850.9451.1869.5283.3%
Cigna77333professional677.14156.36215.2184%
UnitedHealthcare77333professional690.57117.95186.69168.9%
Aetna77333professional569.33116.43198.64188.6%
Aetna77336professional534.8752.5490.76100%
Cigna77373professional51566.622413.54250002406.4%
UnitedHealthcare77373professional52300023000230002213.8%

Median rate by payer, percent of Medicare

Solid line 100% of Medicare.

Median published rate as a percent of locality-adjusted Medicare: UnitedHealthcare 187 percent, Cigna 160 percent, Aetna 130 percent.UnitedHealthcare187%Cigna160%Aetna130%

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