What does uhc pay ent groups in FL?
Median published rate is 92.7% of Medicare across 456 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 185 procedure codes and 1 payer, the median published rate is 115 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 115 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 456 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 | 456 | 109.27 | 125.97 | 179.31 | 92.7% |
| UnitedHealthcare | 99213 | professional | 455 | 73.55 | 85.72 | 124.87 | 88.9% |
| UnitedHealthcare | 99204 | professional | 438 | 168.13 | 190.31 | 241.29 | 107% |
| UnitedHealthcare | 31575 | professional | 389 | 110.16 | 122.05 | 158.62 | 97.2% |
| UnitedHealthcare | 99203 | professional | 378 | 102.41 | 114.96 | 155.61 | 97.7% |
| UnitedHealthcare | 31231 | professional | 369 | 147.59 | 172.71 | 201.13 | 86.5% |
| UnitedHealthcare | 69210 | professional | 367 | 46.89 | 51.73 | 65.3 | 108.2% |
| UnitedHealthcare | 92567 | professional | 170 | 14.05 | 16.58 | 21.28 | 104.3% |
| UnitedHealthcare | 92557 | professional | 163 | 38.55 | 52.51 | 53.12 | 144% |
| UnitedHealthcare | 99212 | professional | 138 | 42.19 | 49.52 | 72.51 | 83.4% |
| UnitedHealthcare | 70486 | professional | 126 | 36.48 | 77.16 | 109.17 | 88% |
| UnitedHealthcare | 95117 | professional | 126 | 11.96 | 12.8 | 14.02 | 105.4% |
| UnitedHealthcare | 31237 | professional | 114 | 234.68 | 267.75 | 338.01 | 97.4% |
| UnitedHealthcare | 95004 | professional | 102 | 5.18 | 6.81 | 8.47 | 183.6% |
| UnitedHealthcare | 92540 | professional | 98 | 48.28 | 96.63 | 123.67 | 126.5% |
| UnitedHealthcare | 92537 | professional | 94 | 14.82 | 38.66 | 49.15 | 126.7% |
| UnitedHealthcare | 95024 | professional | 92 | 5.01 | 5.67 | 5.67 | 70.5% |
| UnitedHealthcare | 92547 | professional | 82 | 7.34 | 8.19 | 16.48 | 77.7% |
| UnitedHealthcare | 92653 | professional | 77 | 104.56 | 111.58 | 130.71 | 139.6% |
| UnitedHealthcare | 99215 | professional | 74 | 156.58 | 197.58 | 259.06 | 101% |
| UnitedHealthcare | 95165 | professional | 72 | 8.82 | 9.93 | 10.54 | 55.7% |
| UnitedHealthcare | 31579 | professional | 68 | 198.94 | 224.67 | 255.51 | 110.6% |
| UnitedHealthcare | 92546 | professional | 64 | 23.08 | 108.01 | 139.36 | 116.7% |
| UnitedHealthcare | 69433 | professional | 53 | 175.74 | 212.6 | 249.12 | 101.3% |
| UnitedHealthcare | 30140 | professional | 46 | 311.02 | 370.98 | 498.39 | 120.9% |
| UnitedHealthcare | 31238 | professional | 45 | 238.43 | 272.68 | 291.67 | 100% |
| UnitedHealthcare | 92588 | professional | 44 | 8.12 | 33.98 | 43.71 | 114.2% |
| UnitedHealthcare | 99205 | professional | 44 | 274.54 | 325.99 | 392.22 | 136.9% |
| UnitedHealthcare | 61782 | professional | 41 | 226.06 | 250.09 | 376.01 | 159.3% |
| UnitedHealthcare | 99202 | professional | 33 | 67.28 | 78.03 | 95.46 | 104.8% |
| UnitedHealthcare | 69220 | professional | 32 | 81.06 | 103.15 | 111.05 | 123.5% |
| UnitedHealthcare | 30520 | professional | 31 | 773.17 | 800.92 | 1105.82 | 128.6% |
| UnitedHealthcare | 69200 | professional | 28 | 75.42 | 92.3 | 102.23 | 108% |
| UnitedHealthcare | 30901 | professional | 25 | 97.05 | 102.88 | 131.66 | 63% |
| UnitedHealthcare | 31295 | professional | 25 | 1064.36 | 1186.38 | 1369.33 | 74.2% |
| UnitedHealthcare | 92511 | professional | 20 | 83.58 | 93.15 | 113.08 | 78.8% |
| UnitedHealthcare | 95115 | professional | 20 | 9.04 | 11.07 | 12.38 | 102.9% |
| UnitedHealthcare | 31267 | professional | 19 | 358.53 | 411.49 | 594.51 | 176.6% |
| UnitedHealthcare | 30801 | professional | 18 | 199.13 | 222.46 | 232.76 | 101.4% |
| UnitedHealthcare | 64582 | professional | 18 | 1086.32 | 1446.76 | 1826.47 | 193.6% |
| UnitedHealthcare | 14060 | professional | 16 | 679.79 | 752.19 | 1026.36 | 95.4% |
| UnitedHealthcare | 38724 | professional | 16 | 2526.8 | 2794.16 | 3231.44 | 206.2% |
| UnitedHealthcare | 10005 | professional | 15 | 113.06 | 118.38 | 125.23 | 89.9% |
| UnitedHealthcare | 31298 | professional | 15 | 1945.74 | 2146.23 | 2392.66 | 71.1% |
| UnitedHealthcare | 92520 | professional | 14 | 63.14 | 67.78 | 72.41 | 76.8% |
| UnitedHealthcare | 69801 | professional | 13 | 206.01 | 216 | 353.28 | 115.3% |
| UnitedHealthcare | 92549 | professional | 13 | 24.91 | 45.72 | 63.64 | 107.3% |
| UnitedHealthcare | 97112 | professional | 13 | 24.81 | 24.81 | 24.81 | 77% |
| UnitedHealthcare | 14040 | professional | 12 | 653.77 | 741.46 | 916.71 | 92.5% |
| UnitedHealthcare | 31276 | professional | 12 | 532.84 | 621.89 | 849.33 | 184.1% |
| UnitedHealthcare | 69420 | professional | 12 | 146.13 | 171.45 | 185.67 | 92.3% |
| UnitedHealthcare | 69222 | professional | 11 | 195 | 225.34 | 283.24 | 101.7% |
| UnitedHealthcare | 97530 | professional | 11 | 27.59 | 27.59 | 29.64 | 80.3% |
| UnitedHealthcare | 99490 | professional | 11 | 89.66 | 89.66 | 89.66 | 126.4% |
| UnitedHealthcare | 30469 | professional | 10 | 1436.04 | 1653.58 | 1733.32 | 70% |
| UnitedHealthcare | 69930 | professional | 10 | 1554.74 | 2130.12 | 3063.48 | 196.3% |
| UnitedHealthcare | 64617 | professional | 9 | 195.18 | 213.02 | 238.42 | 133.6% |
| UnitedHealthcare | 92542 | professional | 9 | 7.1 | 37.49 | 40.88 | 150.9% |
| UnitedHealthcare | 10005 | facility | 8 | 387.75 | 535.35 | 790 | 137.8% |
| UnitedHealthcare | 10021 | facility | 8 | 112.75 | 276 | 414.91 | 435.1% |
| UnitedHealthcare | 11640 | facility | 8 | 387.75 | 558.27 | 790 | 393.2% |
| UnitedHealthcare | 11641 | facility | 8 | 387.75 | 563.97 | 790 | 356% |
| UnitedHealthcare | 11642 | facility | 8 | 387.75 | 569.17 | 790 | 329.9% |
| UnitedHealthcare | 11643 | facility | 8 | 387.75 | 574.87 | 790 | 300.5% |
| UnitedHealthcare | 14040 | facility | 8 | 650 | 1040.5 | 1286.02 | 92.2% |
| UnitedHealthcare | 14041 | facility | 8 | 650 | 1040.5 | 1286.02 | 92.2% |
| UnitedHealthcare | 14060 | facility | 8 | 650 | 1040.5 | 1286.02 | 92.2% |
| UnitedHealthcare | 14061 | facility | 8 | 650 | 1040.5 | 1286.02 | 92.2% |
| UnitedHealthcare | 15823 | facility | 8 | 650 | 1040.5 | 1286.02 | 92.2% |
| UnitedHealthcare | 19296 | facility | 8 | 2675 | 3561.5 | 6608.86 | 79.7% |
| UnitedHealthcare | 19298 | facility | 8 | 2675 | 3561.5 | 5565.2 | 61.4% |
| UnitedHealthcare | 20526 | facility | 8 | 112.75 | 276 | 405.6 | 530.5% |
| UnitedHealthcare | 20550 | facility | 8 | 112.75 | 276 | 397.43 | 830.6% |
| UnitedHealthcare | 20551 | facility | 8 | 112.75 | 276 | 398.2 | 822.2% |
| UnitedHealthcare | 20552 | facility | 8 | 112.75 | 276 | 399.71 | 978.7% |
| UnitedHealthcare | 20553 | facility | 8 | 112.75 | 276 | 402.37 | 838.9% |
| UnitedHealthcare | 20600 | facility | 8 | 112.75 | 276 | 396.86 | 856.6% |
| UnitedHealthcare | 20604 | facility | 8 | 112.75 | 276 | 406.36 | 504.4% |
| UnitedHealthcare | 20605 | facility | 8 | 112.75 | 276 | 397.43 | 847.7% |
| UnitedHealthcare | 20606 | facility | 8 | 387.75 | 525.34 | 790 | 909.9% |
| UnitedHealthcare | 20610 | facility | 8 | 112.75 | 276 | 400.09 | 708.8% |
| UnitedHealthcare | 20611 | facility | 8 | 112.75 | 276 | 411.3 | 430.6% |
| UnitedHealthcare | 20680 | facility | 8 | 1239.75 | 1949.21 | 2200 | 156.2% |
| UnitedHealthcare | 21315 | facility | 8 | 650 | 963.57 | 1252.25 | 146.2% |
| UnitedHealthcare | 21320 | facility | 8 | 650 | 1040.5 | 1367 | 70.3% |
| UnitedHealthcare | 21555 | facility | 8 | 650 | 977.53 | 1252.25 | 131.7% |
| UnitedHealthcare | 22510 | facility | 8 | 1894 | 3171.66 | 3881 | 192.9% |
| UnitedHealthcare | 22511 | facility | 8 | 1894 | 3171.66 | 3881 | 192.9% |
| UnitedHealthcare | 22513 | facility | 8 | 2675 | 3561.5 | 5886.36 | 96.4% |
| UnitedHealthcare | 22514 | facility | 8 | 2675 | 4764.57 | 6746.25 | 129% |
| UnitedHealthcare | 22551 | facility | 8 | 3021.5 | 13350 | 14969.78 | 147.8% |
| UnitedHealthcare | 22558 | facility | 8 | 5251 | 13021.5 | 23801 | 64.8% |
| UnitedHealthcare | 22600 | facility | 8 | 5251 | 10337 | 11002.75 | 78.9% |
| UnitedHealthcare | 22612 | facility | 8 | 3021.5 | 12826.53 | 13223 | 95.1% |
| UnitedHealthcare | 22630 | facility | 8 | 5251 | 11475 | 19174 | 55% |
| UnitedHealthcare | 22633 | facility | 8 | 8007.5 | 12449 | 19174 | 59.8% |
| UnitedHealthcare | 22800 | facility | 8 | 5251 | 7738 | 10337 | 57.4% |
| UnitedHealthcare | 22802 | facility | 8 | 5251 | 7738 | 10337 | 55.6% |
| UnitedHealthcare | 22804 | facility | 8 | 5251 | 7738 | 10337 | 55.6% |
| UnitedHealthcare | 22810 | facility | 8 | 5251 | 7738 | 10337 | 55.6% |
| UnitedHealthcare | 22812 | facility | 8 | 5251 | 7738 | 10337 | 55.6% |
| UnitedHealthcare | 22849 | facility | 8 | 5251 | 7738 | 10337 | 84% |
| UnitedHealthcare | 22850 | facility | 8 | 2675 | 3561.5 | 7057 | 96.4% |
| UnitedHealthcare | 22852 | facility | 8 | 2675 | 3561.5 | 7057 | 96.4% |
| UnitedHealthcare | 22855 | facility | 8 | 2675 | 3561.5 | 7057 | 96.4% |
| UnitedHealthcare | 22856 | facility | 8 | 2675 | 10231 | 18612.14 | 78.1% |
| UnitedHealthcare | 22861 | facility | 8 | 5251 | 9068.5 | 10337 | 77.6% |
| UnitedHealthcare | 23472 | facility | 8 | 5251 | 13069 | 22479 | 94% |
| UnitedHealthcare | 24500 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 24505 | facility | 8 | 112.75 | 276 | 614 | 31.6% |
| UnitedHealthcare | 25600 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 25605 | facility | 8 | 387.75 | 604 | 1022.84 | 69.2% |
| UnitedHealthcare | 25607 | facility | 8 | 2675 | 4765 | 6535.82 | 95.9% |
| UnitedHealthcare | 25608 | facility | 8 | 2675 | 4765 | 6526.72 | 95.7% |
| UnitedHealthcare | 25609 | facility | 8 | 2675 | 4765 | 6535.38 | 95% |
| UnitedHealthcare | 26055 | facility | 8 | 650 | 1025.48 | 1252.25 | 117.5% |
| UnitedHealthcare | 26160 | facility | 8 | 650 | 1025.48 | 1252.25 | 117.5% |
| UnitedHealthcare | 26600 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 27130 | facility | 8 | 5251 | 14687.5 | 22976 | 152.8% |
| UnitedHealthcare | 27134 | facility | 8 | 5251 | 14687.5 | 22406 | 157.5% |
| UnitedHealthcare | 27236 | facility | 8 | 2675 | 3561.5 | 7057 | 73% |
| UnitedHealthcare | 27245 | facility | 8 | 2242.75 | 3227 | 5820 | 66.8% |
| UnitedHealthcare | 27278 | facility | 8 | 5251 | 7738 | 10337 | 51.4% |
| UnitedHealthcare | 27279 | facility | 8 | 5251 | 9068.5 | 11322.9 | 62.5% |
| UnitedHealthcare | 27280 | facility | 8 | 5251 | 7738 | 28138 | 56.1% |
| UnitedHealthcare | 27446 | facility | 8 | 5251 | 13875 | 16411.31 | 150.6% |
| UnitedHealthcare | 27447 | facility | 8 | 5251 | 15875 | 19201.72 | 169% |
| UnitedHealthcare | 27486 | facility | 8 | 5251 | 10844 | 22891 | 159.4% |
| UnitedHealthcare | 27487 | facility | 8 | 5251 | 10844 | 22891 | 77.7% |
| UnitedHealthcare | 27750 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 27752 | facility | 8 | 650 | 1025.48 | 1252.25 | 117.5% |
| UnitedHealthcare | 27786 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 27808 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 27816 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 28470 | facility | 8 | 112.75 | 276 | 441.11 | 203.6% |
| UnitedHealthcare | 29515 | facility | 8 | 112.75 | 276 | 405.98 | 498.3% |
| UnitedHealthcare | 29540 | facility | 8 | 112.75 | 276 | 391.16 | 1912.7% |
| UnitedHealthcare | 29580 | facility | 8 | 112.75 | 276 | 405.98 | 642.3% |
| UnitedHealthcare | 29805 | facility | 8 | 1894 | 2821.66 | 3220.25 | 171.6% |
| UnitedHealthcare | 29806 | facility | 8 | 3021.5 | 3580.5 | 5886.36 | 96.9% |
| UnitedHealthcare | 29807 | facility | 8 | 3021.5 | 3580.5 | 5886.36 | 96.9% |
| UnitedHealthcare | 29819 | facility | 8 | 3021.5 | 3580.5 | 5087.74 | 217.7% |
| UnitedHealthcare | 29820 | facility | 8 | 3021.5 | 3580.5 | 6908.86 | 96.9% |
| UnitedHealthcare | 29821 | facility | 8 | 3021.5 | 3580.5 | 5087.74 | 217.7% |
| UnitedHealthcare | 29822 | facility | 8 | 1894 | 2821.66 | 3220.25 | 171.6% |
| UnitedHealthcare | 29823 | facility | 8 | 3021.5 | 3580.5 | 5087.74 | 217.7% |
| UnitedHealthcare | 29824 | facility | 8 | 3021.5 | 3580.5 | 5087.74 | 217.7% |
| UnitedHealthcare | 29825 | facility | 8 | 3021.5 | 3580.5 | 5087.74 | 217.7% |
| UnitedHealthcare | 29827 | facility | 8 | 3021.5 | 3580.5 | 5886.36 | 96.9% |
| UnitedHealthcare | 29828 | facility | 8 | 3021.5 | 3580.5 | 5886.36 | 96.9% |
| UnitedHealthcare | 29870 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29873 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29874 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29875 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29876 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29877 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29879 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29880 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29881 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29882 | facility | 8 | 1894 | 2598.5 | 3102.74 | 158% |
| UnitedHealthcare | 29888 | facility | 8 | 3021.5 | 5373.54 | 6695.5 | 111.6% |
| UnitedHealthcare | 29889 | facility | 8 | 3021.5 | 5778.5 | 7519.28 | 58.2% |
| UnitedHealthcare | 29891 | facility | 8 | 2675 | 3561.5 | 5087.74 | 216.6% |
| UnitedHealthcare | 29894 | facility | 8 | 1894 | 2323.5 | 3102.74 | 141.3% |
| UnitedHealthcare | 29895 | facility | 8 | 1894 | 2323.5 | 3102.74 | 141.3% |
| UnitedHealthcare | 29914 | facility | 8 | 2675 | 4256 | 5886.36 | 115.2% |
| UnitedHealthcare | 29915 | facility | 8 | 2675 | 4256 | 5886.36 | 115.2% |
| UnitedHealthcare | 29916 | facility | 8 | 2675 | 4256 | 5886.36 | 115.2% |
| UnitedHealthcare | 30115 | facility | 8 | 1239.75 | 1970.52 | 2200 | 133.1% |
| UnitedHealthcare | 30130 | facility | 8 | 1239.75 | 1970.52 | 2200 | 133.1% |
| UnitedHealthcare | 30140 | facility | 8 | 1239.75 | 1970.52 | 2200 | 133.1% |
| UnitedHealthcare | 30420 | facility | 8 | 2242.75 | 3227 | 4820.12 | 106.7% |
| UnitedHealthcare | 30450 | facility | 8 | 2242.75 | 3227 | 4820.12 | 106.7% |
| UnitedHealthcare | 30465 | facility | 8 | 2242.75 | 3227 | 4820.12 | 106.7% |
| UnitedHealthcare | 30468 | facility | 8 | 2242.75 | 3227 | 5820 | 77.1% |
| UnitedHealthcare | 30469 | facility | 8 | 2242.75 | 3227 | 5820 | 79.9% |
| UnitedHealthcare | 30520 | facility | 8 | 1239.75 | 1970.52 | 2200 | 133.1% |
| UnitedHealthcare | 30801 | facility | 8 | 650 | 963.57 | 1252.25 | 146.2% |
| UnitedHealthcare | 30802 | facility | 8 | 650 | 963.57 | 1252.25 | 146.2% |
| UnitedHealthcare | 30802 | professional | 8 | 194.26 | 285.17 | 345.56 | 98.7% |
| UnitedHealthcare | 30903 | facility | 8 | 112.75 | 276 | 412.75 | 375.4% |
| UnitedHealthcare | 30905 | facility | 8 | 112.75 | 276 | 412.75 | 375.4% |
| UnitedHealthcare | 30906 | facility | 8 | 112.75 | 276 | 437.92 | 213.2% |
| UnitedHealthcare | 31231 | facility | 8 | 112.75 | 276 | 425.4 | 251.5% |
| UnitedHealthcare | 31237 | facility | 8 | 650 | 989.92 | 1252.25 | 117.4% |
| UnitedHealthcare | 31238 | facility | 8 | 650 | 989.92 | 1252.25 | 117.4% |
| UnitedHealthcare | 31239 | facility | 8 | 1239.75 | 2034.62 | 2557 | 120% |
| UnitedHealthcare | 31240 | facility | 8 | 1239.75 | 1814.92 | 2557 | 215.1% |
| UnitedHealthcare | 31253 | facility | 8 | 1894 | 2665.5 | 3423.66 | 108.8% |
| UnitedHealthcare | 31254 | facility | 8 | 1239.75 | 2239.5 | 2570.05 | 91.4% |
| UnitedHealthcare | 31254 | professional | 8 | 358.84 | 424.37 | 459.3 | 94.5% |
| UnitedHealthcare | 31255 | facility | 8 | 1894 | 2665.5 | 3423.66 | 108.8% |
| UnitedHealthcare | 31256 | professional | 8 | 203.77 | 245.91 | 270.25 | 149.3% |
| UnitedHealthcare | 31256 | facility | 8 | 1239.75 | 2034.62 | 2557 | 120% |
| UnitedHealthcare | 31257 | facility | 8 | 1894 | 2760.61 | 3881 | 112.7% |
| UnitedHealthcare | 31259 | facility | 8 | 1894 | 2760.61 | 3881 | 112.7% |
| UnitedHealthcare | 31267 | facility | 8 | 1239.75 | 2239.5 | 2570.05 | 91.4% |
| UnitedHealthcare | 31276 | facility | 8 | 1894 | 2760.61 | 3552.5 | 112.7% |
| UnitedHealthcare | 31287 | facility | 8 | 1894 | 2760.61 | 3552.5 | 112.7% |
| UnitedHealthcare | 31288 | facility | 8 | 1894 | 2760.61 | 3552.5 | 112.7% |
ASC versus hospital savings appears only when a hospital outpatient rate is published. Hospital OPPS is not in this phase.
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