What does uhc pay ent groups in GA?
Median published rate is 131.2% of Medicare across 233 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 195 procedure codes and 1 payer, the median published rate is 94 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 94 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 233 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 | 99213 | professional | 233 | 89.7 | 126.83 | 136.46 | 131.2% |
| UnitedHealthcare | 99214 | professional | 227 | 131.83 | 187.33 | 199.9 | 136.8% |
| UnitedHealthcare | 99204 | professional | 212 | 208.04 | 269.46 | 307.59 | 157.4% |
| UnitedHealthcare | 99203 | professional | 206 | 129.2 | 172.39 | 198.15 | 144.2% |
| UnitedHealthcare | 31575 | professional | 199 | 142.56 | 203.97 | 281.01 | 160.5% |
| UnitedHealthcare | 31231 | professional | 174 | 188.1 | 269.91 | 357.41 | 145.7% |
| UnitedHealthcare | 69210 | professional | 168 | 64.05 | 83.28 | 99.48 | 179.5% |
| UnitedHealthcare | 92567 | professional | 108 | 19.45 | 32.67 | 41.91 | 206.3% |
| UnitedHealthcare | 70486 | professional | 85 | 104.95 | 176.34 | 258.63 | 249.7% |
| UnitedHealthcare | 92557 | professional | 76 | 56.32 | 91.33 | 104.98 | 267.5% |
| UnitedHealthcare | 99212 | professional | 71 | 49.08 | 69.61 | 80.01 | 124% |
| UnitedHealthcare | 95117 | professional | 37 | 17.22 | 28.75 | 33.05 | 258.5% |
| UnitedHealthcare | 31237 | professional | 35 | 302.83 | 396.57 | 594.02 | 145.8% |
| UnitedHealthcare | 95165 | professional | 34 | 12.99 | 21.03 | 22.65 | 133% |
| UnitedHealthcare | 95004 | professional | 27 | 6.05 | 8.64 | 9.93 | 253.1% |
| UnitedHealthcare | 99215 | professional | 27 | 160.99 | 203.39 | 351.25 | 104.8% |
| UnitedHealthcare | 99202 | professional | 25 | 89.53 | 96.18 | 118.91 | 131.5% |
| UnitedHealthcare | 31579 | professional | 24 | 240.26 | 377.92 | 451.27 | 199% |
| UnitedHealthcare | 92511 | professional | 22 | 107.47 | 176.06 | 240.17 | 166.3% |
| UnitedHealthcare | 99205 | professional | 22 | 238.91 | 285.23 | 403.2 | 122.8% |
| UnitedHealthcare | 95024 | professional | 21 | 6.55 | 10.56 | 12.14 | 151.1% |
| UnitedHealthcare | 95115 | professional | 17 | 24.11 | 24.11 | 24.11 | 258.2% |
| UnitedHealthcare | 69433 | professional | 14 | 283.19 | 308.9 | 403.24 | 164.2% |
| UnitedHealthcare | 30140 | professional | 13 | 357.57 | 397.9 | 489.14 | 143.6% |
| UnitedHealthcare | 92588 | professional | 13 | 21.37 | 53.99 | 76.47 | 186.1% |
| UnitedHealthcare | 96372 | professional | 11 | 29.03 | 38.69 | 38.69 | 268.3% |
| UnitedHealthcare | 97112 | professional | 11 | 45.62 | 45.62 | 45.62 | 146.7% |
| UnitedHealthcare | 10005 | facility | 10 | 426 | 432.5 | 463.25 | 111.3% |
| UnitedHealthcare | 10021 | facility | 10 | 82.5 | 88 | 109 | 138.7% |
| UnitedHealthcare | 11640 | facility | 10 | 426 | 432.5 | 463.25 | 304.6% |
| UnitedHealthcare | 11641 | facility | 10 | 426 | 432.5 | 463.25 | 273% |
| UnitedHealthcare | 11642 | facility | 10 | 426 | 432.5 | 463.25 | 250.7% |
| UnitedHealthcare | 11643 | facility | 10 | 426 | 432.5 | 463.25 | 226.1% |
| UnitedHealthcare | 14040 | facility | 10 | 655.25 | 739.5 | 788.5 | 65.5% |
| UnitedHealthcare | 14041 | facility | 10 | 655.25 | 739.5 | 788.5 | 65.5% |
| UnitedHealthcare | 14060 | facility | 10 | 655.25 | 739.5 | 788.5 | 65.5% |
| UnitedHealthcare | 14061 | facility | 10 | 655.25 | 739.5 | 788.5 | 65.5% |
| UnitedHealthcare | 15823 | facility | 10 | 655.25 | 739.5 | 788.5 | 65.5% |
| UnitedHealthcare | 19296 | facility | 10 | 2744.5 | 3470 | 3886 | 77.7% |
| UnitedHealthcare | 19298 | facility | 10 | 2744.5 | 3470 | 3886 | 59.8% |
| UnitedHealthcare | 20526 | facility | 10 | 82.5 | 88 | 109 | 169.1% |
| UnitedHealthcare | 20550 | facility | 10 | 82.5 | 88 | 109 | 264.9% |
| UnitedHealthcare | 20551 | facility | 10 | 82.5 | 88 | 109 | 262.2% |
| UnitedHealthcare | 20552 | facility | 10 | 82.5 | 88 | 109 | 312.1% |
| UnitedHealthcare | 20553 | facility | 10 | 82.5 | 88 | 109 | 267.5% |
| UnitedHealthcare | 20600 | facility | 10 | 82.5 | 88 | 109 | 273.1% |
| UnitedHealthcare | 20604 | facility | 10 | 82.5 | 88 | 109 | 160.8% |
| UnitedHealthcare | 20605 | facility | 10 | 82.5 | 88 | 109 | 270.3% |
| UnitedHealthcare | 20606 | facility | 10 | 426 | 432.5 | 463.25 | 749.1% |
| UnitedHealthcare | 20610 | facility | 10 | 82.5 | 88 | 109 | 226% |
| UnitedHealthcare | 20611 | facility | 10 | 82.5 | 88 | 109 | 137.3% |
| UnitedHealthcare | 20680 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 132.5% |
| UnitedHealthcare | 21315 | facility | 10 | 655.25 | 739.5 | 788.5 | 112.2% |
| UnitedHealthcare | 21320 | facility | 10 | 655.25 | 739.5 | 788.5 | 50% |
| UnitedHealthcare | 21555 | facility | 10 | 655.25 | 739.5 | 788.5 | 99.7% |
| UnitedHealthcare | 22510 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 22511 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 22513 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 22514 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 22551 | facility | 10 | 2744.5 | 3470 | 3886 | 38.5% |
| UnitedHealthcare | 22558 | facility | 10 | 3980 | 5994.5 | 7298.5 | 29.8% |
| UnitedHealthcare | 22600 | facility | 10 | 3980 | 5994.5 | 7298.5 | 45.8% |
| UnitedHealthcare | 22612 | facility | 10 | 2744.5 | 3470 | 3886 | 25.7% |
| UnitedHealthcare | 22630 | facility | 10 | 3980 | 5994.5 | 7298.5 | 28.7% |
| UnitedHealthcare | 22633 | facility | 10 | 5745 | 8181 | 10385.25 | 39.3% |
| UnitedHealthcare | 22800 | facility | 10 | 3980 | 5994.5 | 7298.5 | 44.5% |
| UnitedHealthcare | 22802 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43% |
| UnitedHealthcare | 22804 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43% |
| UnitedHealthcare | 22810 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43% |
| UnitedHealthcare | 22812 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43% |
| UnitedHealthcare | 22849 | facility | 10 | 3980 | 5994.5 | 7298.5 | 65.1% |
| UnitedHealthcare | 22850 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 22852 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 22855 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 22856 | facility | 10 | 2744.5 | 3470 | 3886 | 26.5% |
| UnitedHealthcare | 22861 | facility | 10 | 3980 | 5994.5 | 7298.5 | 51.3% |
| UnitedHealthcare | 23472 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43.1% |
| UnitedHealthcare | 24500 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 24505 | facility | 10 | 82.5 | 88 | 109 | 10.1% |
| UnitedHealthcare | 25600 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 25605 | facility | 10 | 426 | 432.5 | 463.25 | 49.6% |
| UnitedHealthcare | 25607 | facility | 10 | 2744.5 | 3470 | 3886 | 69.8% |
| UnitedHealthcare | 25608 | facility | 10 | 2744.5 | 3470 | 3886 | 69.7% |
| UnitedHealthcare | 25609 | facility | 10 | 2744.5 | 3470 | 3886 | 69.2% |
| UnitedHealthcare | 26055 | facility | 10 | 655.25 | 739.5 | 788.5 | 84.8% |
| UnitedHealthcare | 26160 | facility | 10 | 655.25 | 739.5 | 788.5 | 84.8% |
| UnitedHealthcare | 26600 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 27130 | facility | 10 | 3980 | 5994.5 | 7298.5 | 62.4% |
| UnitedHealthcare | 27134 | facility | 10 | 3980 | 5994.5 | 7298.5 | 64.3% |
| UnitedHealthcare | 27236 | facility | 10 | 2744.5 | 3470 | 3886 | 71.1% |
| UnitedHealthcare | 27245 | facility | 10 | 2400 | 2888.5 | 3275 | 59.8% |
| UnitedHealthcare | 27278 | facility | 10 | 3980 | 5994.5 | 7298.5 | 39.8% |
| UnitedHealthcare | 27279 | facility | 10 | 3980 | 5994.5 | 7298.5 | 41.3% |
| UnitedHealthcare | 27280 | facility | 10 | 3980 | 5994.5 | 7298.5 | 43.4% |
| UnitedHealthcare | 27446 | facility | 10 | 3980 | 5994.5 | 7298.5 | 65.1% |
| UnitedHealthcare | 27447 | facility | 10 | 3980 | 5994.5 | 7298.5 | 63.8% |
| UnitedHealthcare | 27486 | facility | 10 | 3980 | 5994.5 | 7298.5 | 88.1% |
| UnitedHealthcare | 27487 | facility | 10 | 3980 | 5994.5 | 7298.5 | 42.9% |
| UnitedHealthcare | 27750 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 27752 | facility | 10 | 655.25 | 739.5 | 788.5 | 84.8% |
| UnitedHealthcare | 27786 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 27808 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 27816 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 28470 | facility | 10 | 82.5 | 88 | 109 | 65% |
| UnitedHealthcare | 29515 | facility | 10 | 82.5 | 88 | 109 | 158.9% |
| UnitedHealthcare | 29540 | facility | 10 | 82.5 | 88 | 109 | 609.9% |
| UnitedHealthcare | 29580 | facility | 10 | 82.5 | 88 | 109 | 204.8% |
| UnitedHealthcare | 29805 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29806 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29807 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29819 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29820 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29821 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29822 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29823 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29824 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29825 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29827 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29828 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29870 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29873 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29874 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29875 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29876 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29877 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29879 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29880 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29881 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29882 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29888 | facility | 10 | 2744.5 | 3470 | 3886 | 72.1% |
| UnitedHealthcare | 29889 | facility | 10 | 2744.5 | 3470 | 3886 | 35% |
| UnitedHealthcare | 29891 | facility | 10 | 2744.5 | 3470 | 3886 | 211% |
| UnitedHealthcare | 29894 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29895 | facility | 10 | 1831.25 | 2068 | 2204 | 125.8% |
| UnitedHealthcare | 29914 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29915 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 29916 | facility | 10 | 2744.5 | 3470 | 3886 | 93.9% |
| UnitedHealthcare | 30115 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 111.8% |
| UnitedHealthcare | 30130 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 111.8% |
| UnitedHealthcare | 30140 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 111.8% |
| UnitedHealthcare | 30420 | facility | 10 | 2400 | 2888.5 | 3275 | 95.5% |
| UnitedHealthcare | 30450 | facility | 10 | 2400 | 2888.5 | 3275 | 95.5% |
| UnitedHealthcare | 30465 | facility | 10 | 2400 | 2888.5 | 3275 | 95.5% |
| UnitedHealthcare | 30468 | facility | 10 | 2400 | 2888.5 | 3275 | 69% |
| UnitedHealthcare | 30469 | facility | 10 | 2400 | 2888.5 | 3275 | 71.5% |
| UnitedHealthcare | 30520 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 111.8% |
| UnitedHealthcare | 30801 | facility | 10 | 655.25 | 739.5 | 788.5 | 112.2% |
| UnitedHealthcare | 30802 | facility | 10 | 655.25 | 739.5 | 788.5 | 112.2% |
| UnitedHealthcare | 30903 | facility | 10 | 82.5 | 88 | 109 | 119.7% |
| UnitedHealthcare | 30905 | facility | 10 | 82.5 | 88 | 109 | 119.7% |
| UnitedHealthcare | 30906 | facility | 10 | 82.5 | 88 | 109 | 68% |
| UnitedHealthcare | 31231 | facility | 10 | 82.5 | 88 | 109 | 80.2% |
| UnitedHealthcare | 31237 | facility | 10 | 655.25 | 739.5 | 788.5 | 87.7% |
| UnitedHealthcare | 31238 | facility | 10 | 655.25 | 739.5 | 788.5 | 87.7% |
| UnitedHealthcare | 31239 | facility | 10 | 1611.75 | 1731.5 | 1981.25 | 102.1% |
| UnitedHealthcare | 31240 | facility | 10 | 1611.75 | 1731.5 | 1981.25 | 205.2% |
| UnitedHealthcare | 31253 | facility | 10 | 1836.5 | 2159.5 | 2270 | 88.1% |
| UnitedHealthcare | 31254 | facility | 10 | 1611.75 | 1731.5 | 1981.25 | 70.7% |
| UnitedHealthcare | 31255 | facility | 10 | 2005.25 | 2070 | 2270 | 84.5% |
| UnitedHealthcare | 31256 | facility | 10 | 1611.75 | 1731.5 | 1981.25 | 102.1% |
| UnitedHealthcare | 31257 | facility | 10 | 1836.5 | 2159.5 | 2270 | 88.1% |
| UnitedHealthcare | 31259 | facility | 10 | 1836.5 | 2159.5 | 2270 | 88.1% |
| UnitedHealthcare | 31267 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 67.5% |
| UnitedHealthcare | 31276 | facility | 10 | 1836.5 | 2159.5 | 2270 | 88.1% |
| UnitedHealthcare | 31287 | facility | 10 | 1831.25 | 2068 | 2204 | 84.4% |
| UnitedHealthcare | 31288 | facility | 10 | 1831.25 | 2068 | 2204 | 84.4% |
| UnitedHealthcare | 31295 | facility | 10 | 2005.25 | 2070 | 2270 | 66.7% |
| UnitedHealthcare | 31296 | facility | 10 | 2005.25 | 2070 | 2270 | 138.3% |
| UnitedHealthcare | 31297 | facility | 10 | 1611.75 | 1731.5 | 1981.25 | 55.6% |
| UnitedHealthcare | 31298 | facility | 10 | 1836.5 | 2159.5 | 2270 | 88.1% |
| UnitedHealthcare | 31535 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 97.6% |
| UnitedHealthcare | 31536 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 97.6% |
| UnitedHealthcare | 31540 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 97.6% |
| UnitedHealthcare | 31541 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 97.6% |
| UnitedHealthcare | 31575 | facility | 10 | 82.5 | 88 | 109 | 95% |
| UnitedHealthcare | 31576 | facility | 10 | 655.25 | 739.5 | 788.5 | 87.7% |
| UnitedHealthcare | 31577 | facility | 10 | 82.5 | 88 | 109 | 41% |
| UnitedHealthcare | 31578 | facility | 10 | 655.25 | 739.5 | 788.5 | 43.6% |
| UnitedHealthcare | 31579 | facility | 10 | 82.5 | 88 | 109 | 69.6% |
| UnitedHealthcare | 31600 | facility | 10 | 1499.5 | 1654.5 | 1740.75 | 111.8% |
| UnitedHealthcare | 32555 | facility | 10 | 426 | 432.5 | 463.25 | 125.5% |
| UnitedHealthcare | 33206 | facility | 10 | 3980 | 5994.5 | 7298.5 | 82.3% |
| UnitedHealthcare | 33207 | facility | 10 | 3980 | 5994.5 | 7298.5 | 79.3% |
| UnitedHealthcare | 33208 | facility | 10 | 5745 | 8181 | 10385.25 | 105.7% |
| UnitedHealthcare | 33212 | facility | 10 | 3980 | 5994.5 | 7298.5 | 90.1% |
| UnitedHealthcare | 33213 | facility | 10 | 3980 | 5994.5 | 7298.5 | 78.1% |
| UnitedHealthcare | 33214 | facility | 10 | 5745 | 8181 | 10385.25 | 107.1% |
| UnitedHealthcare | 33216 | facility | 10 | 2744.5 | 3470 | 3886 | 58.7% |
| UnitedHealthcare | 33217 | facility | 10 | 2744.5 | 3470 | 3886 | 53.4% |
| UnitedHealthcare | 33224 | facility | 10 | 5745 | 8181 | 10385.25 | 106.3% |
| UnitedHealthcare | 33226 | facility | 10 | 1831.25 | 2068 | 2204 | 96% |
| UnitedHealthcare | 33227 | facility | 10 | 3980 | 5994.5 | 7298.5 | 93.2% |
| UnitedHealthcare | 33228 | facility | 10 | 3980 | 5994.5 | 7298.5 | 79.4% |
| UnitedHealthcare | 33229 | facility | 10 | 3980 | 5994.5 | 7298.5 | 44.3% |
| UnitedHealthcare | 33230 | facility | 10 | 9100 | 9960 | 23835.75 | 52.6% |
| UnitedHealthcare | 33231 | facility | 10 | 9100 | 9960 | 23835.75 | 39.1% |
| UnitedHealthcare | 33240 | facility | 10 | 9100 | 9960 | 23835.75 | 53.6% |
| UnitedHealthcare | 33241 | facility | 10 | 1831.25 | 2068 | 2204 | 98.9% |
| UnitedHealthcare | 33249 | facility | 10 | 9100 | 9960 | 23835.75 | 40.2% |
| UnitedHealthcare | 33262 | facility | 10 | 9100 | 9960 | 23835.75 | 52.7% |
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