What do payers pay uhc groups in ENT?

Across 1843 NPIs, the median published rate is 96.1% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 23 procedure codes and 3 payers, the median published rate is 98 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 110 percent and Aetna the lowest at 82 percent, a spread of 28 points on identical work. 2 of 3 payers sit at or above Medicare and 1 below it. The best-covered row rests on 1843 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 uhc groups in ENT?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
UnitedHealthcare	99214	professional	1843	92.79	155.76	228.53	96.1%
UnitedHealthcare	99214	professional	1838	100.35	128.34	149.98	91.7%
Cigna	99214	professional	1827	118.6	133.24	165.59	98.6%
Aetna	99214	professional	1818	40	84.03	129.74	70.2%
UnitedHealthcare	99214	professional	1812	89.08	116.85	146.32	84.4%
Cigna	99214	professional	1808	90.05	115.01	139.26	83.4%
Cigna	99214	professional	1798	91.57	145.68	287.59	97.1%
Aetna	99214	professional	1713	44.28	96.83	132.35	81.6%
UnitedHealthcare	93306	professional	1670	120.96	203.81	344.44	131.2%
Aetna	93306	professional	1665	87.71	147.64	203.73	113.3%
UnitedHealthcare	93306	professional	1650	109.13	171.61	259.23	135.3%
Cigna	93306	professional	1646	92.01	142.16	236.75	124%
Cigna	93306	professional	1620	169.3	246.84	400.15	154.6%
Aetna	93000	professional	1611	6.84	13.67	19.25	116.7%
Cigna	93306	professional	1609	120.46	194.85	271.37	148.9%
UnitedHealthcare	93306	professional	1609	137	205.99	308.97	172.2%
Cigna	93000	professional	1599	12.51	18.21	26.67	119%
UnitedHealthcare	93000	professional	1593	17.15	21.98	26.52	142%
UnitedHealthcare	93000	professional	1580	23.38	27.72	37.13	198.5%
Cigna	93000	professional	1571	18.75	22.86	30.5	148.9%
UnitedHealthcare	93000	professional	1561	17.59	25.46	44.28	143.5%
Cigna	93000	professional	1533	21.86	27.61	45.72	162.2%
UnitedHealthcare	99204	professional	1520	159.06	185.8	224.36	109.7%
Cigna	99204	professional	1509	165.08	195.74	227.96	110.1%
Aetna	99214	professional	1500	40.54	61.91	110.8	69.8%
Aetna	93306	professional	1485	86.81	147.14	227.66	119.8%
Aetna	99204	professional	1476	45	127.35	203.28	82.1%
Aetna	93000	professional	1475	7.12	15.1	19.98	108.5%
UnitedHealthcare	99204	professional	1469	142.33	184.76	232.65	101.4%
Cigna	99204	professional	1452	128.1	168.9	210.62	94.7%
UnitedHealthcare	99214	professional	1450	90	150	214.45	97.8%
UnitedHealthcare	99213	professional	1426	82.29	100	143.42	94.5%
Cigna	99214	professional	1412	104.29	145.68	252.42	96.7%
Aetna	93306	professional	1408	95.65	195.4	263.27	119.8%
Aetna	99204	professional	1408	45.35	135.78	182.92	88.2%
Cigna	99213	professional	1384	67.46	97.98	162.36	93.1%
UnitedHealthcare	99204	professional	1376	143.35	235.3	322.49	110.2%
UnitedHealthcare	99213	professional	1363	76.15	88.24	111.18	90.8%
Cigna	99204	professional	1347	144.53	204.97	361.78	106.5%
UnitedHealthcare	92134	professional	1340	20.88	32.2	49.75	118.9%
Cigna	99213	professional	1331	73.1	84.72	103.5	89.6%
Aetna	93000	professional	1314	9.86	19.71	24.15	127.5%
UnitedHealthcare	99204	professional	1303	156.45	228.8	322.49	115.5%
Cigna	92134	professional	1302	26.28	39.61	55.37	154.9%
Aetna	99213	professional	1302	42	65.59	82.27	79.8%
UnitedHealthcare	99214	professional	1288	110.42	129.98	157.02	94.6%
Cigna	99204	professional	1272	162.21	218.67	361.78	109%
Cigna	99214	professional	1256	107.02	125.04	153.8	92%
UnitedHealthcare	99215	professional	1240	148.21	251.91	350.71	113.3%
Cigna	99215	professional	1221	141.46	249.21	445.5	117.3%
Aetna	99214	professional	1216	45.35	96.56	116.28	79.5%
Aetna	99214	professional	1214	41	84.93	122.83	73.5%
UnitedHealthcare	92014	professional	1207	83.81	102.95	151.35	72.2%
Aetna	99213	professional	1202	41	63.52	84.93	70.6%
Aetna	92134	professional	1196	19.29	28.42	43.97	123%
Cigna	92014	professional	1185	83.52	106.86	141.36	74.7%
UnitedHealthcare	99213	professional	1168	61.09	76.11	98.52	80%
Aetna	99213	professional	1166	40	59.28	89.47	66.7%
Cigna	99213	professional	1166	72.46	85.33	97.4	89.6%
Aetna	99214	professional	1163	40	88.73	134.88	71.1%
UnitedHealthcare	99214	professional	1161	92.22	113.06	143.97	81.2%
Cigna	99214	professional	1153	105.16	122.91	141.09	90.2%
UnitedHealthcare	99213	professional	1149	73.16	82.91	105.54	86.6%
Cigna	99213	professional	1139	80.62	89.25	111.42	94.5%
UnitedHealthcare	92083	professional	1138	30.1	49.84	80.3	93.8%
Aetna	99204	professional	1130	41	74.47	163.78	82.3%
UnitedHealthcare	99214	professional	1130	85	114.2	198.3	78.1%
Aetna	92014	professional	1128	15.33	93.35	106.62	73.1%
UnitedHealthcare	99204	professional	1121	163.93	198.63	217.55	113.4%
Cigna	92083	professional	1118	38.69	61	89.44	120%
Cigna	99214	professional	1115	87.24	112.81	183.96	75.7%
UnitedHealthcare	92133	professional	1112	18.28	28.35	45.15	115.4%
Aetna	78452	professional	1103	102.6	300.36	423.14	98%
Cigna	78452	professional	1100	86.26	277.73	387.89	82.2%
UnitedHealthcare	78452	professional	1099	84.97	326.91	394.35	92.3%
Cigna	99204	professional	1098	155.57	179.49	220.69	103.5%
Aetna	99204	professional	1089	43.05	107.7	181.61	84%
Cigna	92133	professional	1083	24.53	35.28	54.94	158.9%
Aetna	99213	professional	1078	42	67.99	91.3	80.6%
UnitedHealthcare	93010	professional	1068	9.79	14.56	33.04	158.9%
UnitedHealthcare	99213	professional	1068	60.11	76.15	95.95	79.4%
Aetna	99213	professional	1066	26.1	54.63	79.99	65.8%
Cigna	99213	professional	1066	60.89	75.38	91.82	78.4%
Aetna	99204	professional	1065	46.68	135.78	171.61	88.2%
UnitedHealthcare	43239	professional	1056	270.47	416.67	767.83	91.8%
UnitedHealthcare	99214	professional	1055	126.26	202.08	357.66	145.1%
Aetna	92083	professional	1040	29.29	55.1	81.93	119.7%
Aetna	99204	professional	1038	45	134.81	208.5	82.6%
UnitedHealthcare	99204	professional	1035	146.48	178.29	228.11	97.8%
Cigna	78452	professional	1031	107.89	365.27	499.09	111.1%
Cigna	93010	professional	1031	9.67	15.25	24.41	169.9%
UnitedHealthcare	78452	professional	1029	134.48	467.03	626.13	146.3%
Cigna	99204	professional	1024	147.8	177.23	210.08	97.5%
UnitedHealthcare	93010	professional	1019	8.52	11.61	13.58	137.1%
Cigna	43239	professional	1018	301.5	377.43	553.43	78.2%
Cigna	99214	professional	1018	140.21	214.03	290.77	136.5%
UnitedHealthcare	99204	professional	1015	124.35	169.94	309.16	85.3%
UnitedHealthcare	93010	professional	1013	11.46	14.93	18.74	185.6%
Cigna	93010	professional	1009	6.94	10.92	13.47	127.1%
Aetna	92133	professional	1008	18.72	27.9	43.24	127.3%
UnitedHealthcare	99213	professional	1008	72.98	90	142.68	86.1%
Cigna	93010	professional	1007	10.73	12.32	15.84	150%
UnitedHealthcare	99213	professional	1004	60.58	85	131.78	77.5%
Cigna	99204	professional	1002	136.97	167.35	242.18	84.9%
UnitedHealthcare	99215	professional	991	205.63	314.79	560.79	159.7%
UnitedHealthcare	45380	professional	987	364.28	548.83	931.7	101.6%
Cigna	99213	professional	985	57.79	72.59	119.65	71.2%
UnitedHealthcare	45385	professional	982	392.47	635.12	1034.09	117%
UnitedHealthcare	92012	professional	982	57.42	71.11	101.11	69.5%
Cigna	99213	professional	982	59.56	84.12	142.69	80%
Aetna	93010	professional	973	3.4	6.79	10.13	114.4%
Aetna	99214	professional	965	40.54	49.2	100.96	66.1%
Cigna	92012	professional	964	58.91	72.69	91.03	71%
UnitedHealthcare	20610	professional	962	65.89	79.5	94.16	116.7%
Aetna	78452	professional	961	100.74	319.94	470.6	108.1%
Cigna	99215	professional	961	236	314.05	445.5	146.3%
Cigna	45380	professional	957	401.07	520.96	782.73	89.1%
Cigna	45385	professional	956	465.82	600.79	898.47	101.2%
UnitedHealthcare	99214	professional	951	97.87	173.96	242.25	113.2%
Aetna	20610	professional	947	23.09	45.35	60.86	95.8%
Aetna	43239	professional	941	41.79	79.2	220.71	66%
UnitedHealthcare	99203	professional	936	110.22	129.11	151.32	107.1%
Aetna	92012	professional	935	29.54	65.67	85.48	69.7%
Aetna	99215	professional	934	45	116.06	183.64	67.6%
UnitedHealthcare	20610	professional	933	66.49	85.34	130.16	108.5%
UnitedHealthcare	99205	professional	933	196.66	345.74	534.79	137.3%
Cigna	43239	professional	931	260.55	303.92	395.49	74.3%
UnitedHealthcare	99203	professional	931	103.53	144.75	203.7	105.2%
Aetna	99215	professional	931	41	76.67	158.49	68.7%
UnitedHealthcare	99214	professional	929	127.39	158.59	183	111.3%
UnitedHealthcare	99215	professional	929	133.5	172.07	203.07	86.4%
UnitedHealthcare	43239	professional	928	316.57	421.99	475.08	102.5%
Cigna	99214	professional	927	110.73	163.08	274.83	106%
UnitedHealthcare	92250	professional	926	20.98	34.68	53.36	115.4%
Cigna	93015	professional	926	57.78	75.6	107.88	104.9%
Cigna	20610	professional	925	65.37	77.94	100.52	117.4%
UnitedHealthcare	43239	professional	923	286.21	377.03	533.61	95%
Cigna	99205	professional	920	208.22	363.08	643.73	140.1%
Cigna	43239	professional	919	309.04	384.53	522.58	91.4%
Cigna	99215	professional	918	139.19	167.7	199.23	86.4%
Cigna	99214	professional	913	127.13	161.49	169.34	114.8%
Aetna	43239	professional	912	46.68	164.85	315.61	81.3%
Cigna	92250	professional	912	31.56	58.83	81.44	195.5%
Aetna	93010	professional	912	4.14	8.77	10.92	117%
Cigna	99203	professional	911	98.02	116.25	140.71	100.7%
Cigna	99214	professional	909	142.22	154.62	156.9	114.2%
Cigna	20610	professional	908	63.67	83.71	123.94	107.7%
Aetna	93015	professional	903	30.22	60.52	81.35	104.8%
Aetna	99204	professional	902	41	64.27	152.33	75.9%
UnitedHealthcare	99214	professional	898	124.44	137.89	167.72	112.4%
UnitedHealthcare	93015	professional	896	69.96	86.94	113.9	118%
Aetna	99203	professional	896	42	91.06	111.55	86.2%
Cigna	99203	professional	896	103.26	138.11	212.31	105.1%
UnitedHealthcare	92134	professional	886	20.55	32.48	45.65	148.6%
Aetna	20610	professional	882	13.79	42.5	57.1	86.6%
UnitedHealthcare	92004	professional	881	99.88	122.67	179.7	73.4%
Aetna	92134	professional	878	16.92	23.6	34.21	116%
Aetna	99213	professional	875	29.01	46.74	69.69	64.3%
Aetna	99213	professional	873	31.52	54.94	76.86	67.9%
Cigna	92004	professional	870	109.53	130.45	172.81	77.9%
UnitedHealthcare	92014	professional	866	94.39	113.91	135.59	90.2%
Aetna	92250	professional	863	28.18	41.32	62.53	175.7%
Cigna	99214	professional	863	107.73	130.54	149.75	96.7%
Cigna	92134	professional	862	15.35	21.91	31.59	98.4%
UnitedHealthcare	99205	professional	859	268.05	424.88	691.48	179.1%
UnitedHealthcare	20610	professional	858	59.48	73.42	101.23	103%
UnitedHealthcare	99214	professional	857	105	118.56	139.17	85.3%
Aetna	92134	professional	855	13.82	19.45	29.5	96.9%
Cigna	92134	professional	855	17.99	28.16	42.33	134.9%
Aetna	92014	professional	854	35.37	82.39	104.61	78.5%
Cigna	92014	professional	854	93.76	107.16	130.01	85.8%
Cigna	20610	professional	852	56.79	71.21	90.4	100.9%
UnitedHealthcare	92134	professional	852	16.34	25.03	36.38	115.9%
Cigna	99215	professional	852	173.55	194.34	238.11	103%
UnitedHealthcare	99215	professional	851	141.63	179.89	238.83	94.7%
Cigna	99214	professional	849	119.16	126.47	156.9	95.6%
Aetna	43239	professional	848	43.05	83.39	268.29	59.1%
UnitedHealthcare	99214	professional	848	106.99	128.17	170.3	91%
UnitedHealthcare	45385	professional	847	462.75	629.14	709.65	127.5%
UnitedHealthcare	66984	professional	847	478.94	583.09	909.27	113.2%
UnitedHealthcare	99214	professional	847	88.76	177.05	251.73	133.9%
Cigna	45385	professional	842	472.39	538.67	747.62	111.9%
Aetna	92004	professional	840	18.72	114.17	130.58	76.1%
UnitedHealthcare	45380	professional	839	398.58	542.96	632.48	114.8%
Aetna	99214	professional	839	45	101.33	131.56	78.2%
Aetna	45385	professional	838	53.04	243.41	453.64	95%
UnitedHealthcare	99204	professional	838	156.17	255.86	326.45	130.1%
UnitedHealthcare	99214	professional	837	116.85	151.88	175.5	111%
Aetna	20610	professional	836	38	48.69	67.05	91.5%
Cigna	45380	professional	836	403.85	473.51	666.34	102.8%
Aetna	99214	professional	836	42.5	86.59	149.03	70.2%
Cigna	99205	professional	835	290.79	407.39	631.61	160.4%
Aetna	45380	professional	834	44.62	79.41	300.56	75.3%
Aetna	45385	professional	833	45	84.59	350.44	83.5%
Cigna	66984	professional	833	655.53	748.31	924.98	144.5%
Aetna	45380	professional	831	49.94	235.29	413.52	88.5%
UnitedHealthcare	99215	professional	830	185.16	314.79	549.57	153.3%
Aetna	99214	professional	827	45.78	99.89	142.3	91.5%
UnitedHealthcare	99203	professional	826	91.06	110.83	148.33	93.5%
Cigna	99204	professional	826	168.83	226.84	323.88	115.6%

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