What does uhc pay gastroenterology groups in FL?
Median published rate is 95% of Medicare across 923 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 197 procedure codes and 1 payer, the median published rate is 73 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 73 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 923 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 | 43239 | professional | 923 | 286.21 | 377.03 | 533.61 | 95% |
| UnitedHealthcare | 99214 | professional | 848 | 106.99 | 128.17 | 170.3 | 91% |
| UnitedHealthcare | 45385 | professional | 815 | 420.6 | 555.19 | 761.19 | 108.8% |
| UnitedHealthcare | 45380 | professional | 805 | 371.72 | 468.71 | 678.25 | 99.1% |
| UnitedHealthcare | 99204 | professional | 769 | 158.27 | 202.66 | 250.3 | 105.4% |
| UnitedHealthcare | 99213 | professional | 643 | 73.48 | 86.5 | 106.86 | 85.4% |
| UnitedHealthcare | 99203 | professional | 455 | 98.15 | 119.63 | 140.88 | 98.4% |
| UnitedHealthcare | G0105 | professional | 428 | 309.73 | 392.92 | 561.87 | 105.2% |
| UnitedHealthcare | 45378 | professional | 383 | 301.33 | 391.37 | 512.38 | 102.4% |
| UnitedHealthcare | G0121 | professional | 370 | 310.93 | 392.92 | 564.52 | 105% |
| UnitedHealthcare | 43235 | professional | 343 | 247.92 | 308.78 | 434.78 | 97.8% |
| UnitedHealthcare | 43249 | professional | 216 | 496.62 | 819.93 | 1314.43 | 71% |
| UnitedHealthcare | 99215 | professional | 151 | 154.34 | 175.85 | 252.22 | 88.3% |
| UnitedHealthcare | 43248 | professional | 142 | 262.25 | 332.09 | 502.29 | 72.8% |
| UnitedHealthcare | 99212 | professional | 91 | 36.78 | 49.04 | 70.87 | 79.7% |
| UnitedHealthcare | 43264 | professional | 78 | 542.16 | 676.72 | 774.89 | 202.6% |
| UnitedHealthcare | 43255 | professional | 76 | 410.55 | 488.85 | 646.74 | 72% |
| UnitedHealthcare | 43259 | professional | 71 | 376.2 | 442.38 | 496.73 | 210.6% |
| UnitedHealthcare | 99205 | professional | 69 | 227.86 | 259.85 | 350.62 | 104.8% |
| UnitedHealthcare | 99202 | professional | 65 | 75.6 | 87.13 | 107.45 | 112.3% |
| UnitedHealthcare | 43251 | professional | 63 | 313.97 | 396.42 | 594.96 | 74.1% |
| UnitedHealthcare | 43246 | professional | 61 | 205.36 | 283.89 | 358.23 | 138.1% |
| UnitedHealthcare | 43242 | professional | 60 | 440.56 | 532.11 | 581.59 | 218.8% |
| UnitedHealthcare | 43274 | professional | 59 | 674.23 | 820.28 | 983.93 | 196.9% |
| UnitedHealthcare | 45390 | professional | 59 | 481.67 | 624.74 | 902.37 | 207.9% |
| UnitedHealthcare | 91110 | professional | 56 | 237.8 | 825.45 | 1075.26 | 139.9% |
| UnitedHealthcare | 45381 | professional | 53 | 370.02 | 477.61 | 550.04 | 95.7% |
| UnitedHealthcare | 43239 | facility | 51 | 400 | 500 | 1214 | 100.4% |
| UnitedHealthcare | 45380 | facility | 51 | 400 | 500 | 1214 | 76.1% |
| UnitedHealthcare | 45385 | facility | 51 | 400 | 500 | 1214 | 76.1% |
| UnitedHealthcare | 10005 | facility | 50 | 316.25 | 395 | 1004 | 101.7% |
| UnitedHealthcare | 10021 | facility | 50 | 94 | 231.5 | 603 | 364.9% |
| UnitedHealthcare | 11640 | facility | 50 | 316.25 | 395 | 1004 | 278.2% |
| UnitedHealthcare | 11641 | facility | 50 | 316.25 | 395 | 1004 | 249.3% |
| UnitedHealthcare | 11642 | facility | 50 | 316.25 | 395 | 1004 | 228.9% |
| UnitedHealthcare | 11643 | facility | 50 | 316.25 | 395 | 1004 | 206.5% |
| UnitedHealthcare | 14040 | facility | 50 | 397.5 | 493 | 1214 | 43.7% |
| UnitedHealthcare | 14041 | facility | 50 | 397.5 | 493 | 1214 | 43.7% |
| UnitedHealthcare | 14060 | facility | 50 | 397.5 | 493 | 1214 | 43.7% |
| UnitedHealthcare | 14061 | facility | 50 | 397.5 | 493 | 1214 | 43.7% |
| UnitedHealthcare | 15823 | facility | 50 | 397.5 | 493 | 1214 | 43.7% |
| UnitedHealthcare | 19296 | facility | 50 | 1421.75 | 2189 | 5341.25 | 49% |
| UnitedHealthcare | 19298 | facility | 50 | 1421.75 | 2189 | 5341.25 | 37.7% |
| UnitedHealthcare | 20526 | facility | 50 | 94 | 231.5 | 603 | 444.9% |
| UnitedHealthcare | 20550 | facility | 50 | 94 | 231.5 | 603 | 696.7% |
| UnitedHealthcare | 20551 | facility | 50 | 94 | 231.5 | 603 | 689.6% |
| UnitedHealthcare | 20552 | facility | 50 | 94 | 231.5 | 603 | 820.9% |
| UnitedHealthcare | 20553 | facility | 50 | 94 | 231.5 | 603 | 703.7% |
| UnitedHealthcare | 20600 | facility | 50 | 94 | 231.5 | 603 | 718.5% |
| UnitedHealthcare | 20604 | facility | 50 | 94 | 231.5 | 603 | 423.1% |
| UnitedHealthcare | 20605 | facility | 50 | 94 | 231.5 | 603 | 711% |
| UnitedHealthcare | 20606 | facility | 50 | 316.25 | 395 | 1004 | 684.1% |
| UnitedHealthcare | 20610 | facility | 50 | 94 | 231.5 | 603 | 594.5% |
| UnitedHealthcare | 20611 | facility | 50 | 94 | 231.5 | 603 | 361.1% |
| UnitedHealthcare | 20680 | facility | 50 | 781.75 | 929 | 2398.25 | 74.4% |
| UnitedHealthcare | 21315 | facility | 50 | 397.5 | 493 | 1214 | 74.8% |
| UnitedHealthcare | 21320 | facility | 50 | 397.5 | 493 | 1214 | 33.3% |
| UnitedHealthcare | 21555 | facility | 50 | 397.5 | 493 | 1214 | 66.5% |
| UnitedHealthcare | 22510 | facility | 50 | 831 | 1364 | 3596 | 82.9% |
| UnitedHealthcare | 22511 | facility | 50 | 831 | 1364 | 3596 | 82.9% |
| UnitedHealthcare | 22513 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 22514 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 22551 | facility | 50 | 1447.25 | 2539 | 10404 | 28.1% |
| UnitedHealthcare | 22558 | facility | 50 | 2183.75 | 4749.5 | 11639.25 | 23.7% |
| UnitedHealthcare | 22600 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 36.3% |
| UnitedHealthcare | 22612 | facility | 50 | 1421.75 | 2239 | 5721.25 | 16.6% |
| UnitedHealthcare | 22630 | facility | 50 | 2183.75 | 4900 | 11401.5 | 23.5% |
| UnitedHealthcare | 22633 | facility | 50 | 2189.75 | 6657.5 | 14627.5 | 32% |
| UnitedHealthcare | 22800 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 35.2% |
| UnitedHealthcare | 22802 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 34.1% |
| UnitedHealthcare | 22804 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 34.1% |
| UnitedHealthcare | 22810 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 34.1% |
| UnitedHealthcare | 22812 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 34.1% |
| UnitedHealthcare | 22849 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 51.6% |
| UnitedHealthcare | 22850 | facility | 50 | 1447.25 | 2239 | 5341.25 | 60.6% |
| UnitedHealthcare | 22852 | facility | 50 | 1447.25 | 2239 | 5341.25 | 60.6% |
| UnitedHealthcare | 22855 | facility | 50 | 1447.25 | 2239 | 5341.25 | 60.6% |
| UnitedHealthcare | 22856 | facility | 50 | 1447.25 | 2364 | 13001 | 18.1% |
| UnitedHealthcare | 22861 | facility | 50 | 2183.75 | 4749.5 | 9927.75 | 40.7% |
| UnitedHealthcare | 23472 | facility | 50 | 2183.75 | 5986.5 | 15941.39 | 43.1% |
| UnitedHealthcare | 24500 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 24505 | facility | 50 | 94 | 231.5 | 603 | 26.6% |
| UnitedHealthcare | 25600 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 25605 | facility | 50 | 316.25 | 395 | 1004 | 45.3% |
| UnitedHealthcare | 25607 | facility | 50 | 1447.25 | 2364 | 6622.14 | 47.6% |
| UnitedHealthcare | 25608 | facility | 50 | 1447.25 | 2364 | 5491 | 47.5% |
| UnitedHealthcare | 25609 | facility | 50 | 1447.25 | 2364 | 6644.42 | 47.2% |
| UnitedHealthcare | 26055 | facility | 50 | 397.5 | 493 | 1214 | 56.5% |
| UnitedHealthcare | 26160 | facility | 50 | 397.5 | 493 | 1214 | 56.5% |
| UnitedHealthcare | 26600 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 27130 | facility | 50 | 2183.75 | 5300 | 13257.5 | 55.1% |
| UnitedHealthcare | 27134 | facility | 50 | 2183.75 | 4749.5 | 13043.75 | 51% |
| UnitedHealthcare | 27236 | facility | 50 | 1421.75 | 2189 | 4886.5 | 44.9% |
| UnitedHealthcare | 27245 | facility | 50 | 1144.5 | 1701 | 4528 | 35.2% |
| UnitedHealthcare | 27278 | facility | 50 | 2183.75 | 4900 | 10337 | 32.6% |
| UnitedHealthcare | 27279 | facility | 50 | 2183.75 | 6173 | 10337 | 42.5% |
| UnitedHealthcare | 27280 | facility | 50 | 2183.75 | 5300 | 12478.5 | 38.4% |
| UnitedHealthcare | 27446 | facility | 50 | 2183.75 | 5986.5 | 12970.96 | 65% |
| UnitedHealthcare | 27447 | facility | 50 | 2183.75 | 5986.5 | 14674.13 | 63.7% |
| UnitedHealthcare | 27486 | facility | 50 | 2183.75 | 5986.5 | 13225.63 | 88% |
| UnitedHealthcare | 27487 | facility | 50 | 2183.75 | 5986.5 | 13225.63 | 42.9% |
| UnitedHealthcare | 27750 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 27752 | facility | 50 | 397.5 | 493 | 1214 | 56.5% |
| UnitedHealthcare | 27786 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 27808 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 27816 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 28470 | facility | 50 | 94 | 231.5 | 603 | 170.8% |
| UnitedHealthcare | 29515 | facility | 50 | 94 | 231.5 | 603 | 418% |
| UnitedHealthcare | 29540 | facility | 50 | 94 | 231.5 | 603 | 1604.3% |
| UnitedHealthcare | 29580 | facility | 50 | 94 | 231.5 | 603 | 538.8% |
| UnitedHealthcare | 29805 | facility | 50 | 831 | 1372 | 3479.03 | 83.4% |
| UnitedHealthcare | 29806 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 29807 | facility | 50 | 1447.25 | 2364 | 5544.25 | 64% |
| UnitedHealthcare | 29819 | facility | 50 | 1447.25 | 2364 | 5335.75 | 143.7% |
| UnitedHealthcare | 29820 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 29821 | facility | 50 | 1447.25 | 2364 | 5335.75 | 143.7% |
| UnitedHealthcare | 29822 | facility | 50 | 831 | 1372 | 3572 | 83.4% |
| UnitedHealthcare | 29823 | facility | 50 | 1447.25 | 2364 | 5335.75 | 143.7% |
| UnitedHealthcare | 29824 | facility | 50 | 1447.25 | 2364 | 5335.75 | 143.7% |
| UnitedHealthcare | 29825 | facility | 50 | 1447.25 | 2364 | 5335.75 | 143.7% |
| UnitedHealthcare | 29827 | facility | 50 | 1447.25 | 2364 | 5544.25 | 64% |
| UnitedHealthcare | 29828 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 29870 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29873 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29874 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29875 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29876 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29877 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29879 | facility | 50 | 831 | 1364 | 3551.03 | 82.9% |
| UnitedHealthcare | 29880 | facility | 50 | 831 | 1364 | 3596 | 82.9% |
| UnitedHealthcare | 29881 | facility | 50 | 831 | 1364 | 3596 | 82.9% |
| UnitedHealthcare | 29882 | facility | 50 | 831 | 1364 | 3596 | 82.9% |
| UnitedHealthcare | 29888 | facility | 50 | 1447.25 | 2364 | 5949.5 | 49.1% |
| UnitedHealthcare | 29889 | facility | 50 | 1447.25 | 2364 | 5949.5 | 23.8% |
| UnitedHealthcare | 29891 | facility | 50 | 1421.75 | 2189 | 4886.5 | 133.1% |
| UnitedHealthcare | 29894 | facility | 50 | 831 | 1364 | 3176.45 | 82.9% |
| UnitedHealthcare | 29895 | facility | 50 | 831 | 1364 | 3176.45 | 82.9% |
| UnitedHealthcare | 29914 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 29915 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 29916 | facility | 50 | 1447.25 | 2364 | 5491 | 64% |
| UnitedHealthcare | 30115 | facility | 50 | 781.75 | 929 | 2398.25 | 62.8% |
| UnitedHealthcare | 30130 | facility | 50 | 781.75 | 929 | 2398.25 | 62.8% |
| UnitedHealthcare | 30140 | facility | 50 | 781.75 | 929 | 2398.25 | 62.8% |
| UnitedHealthcare | 30420 | facility | 50 | 1144.5 | 1701 | 4750 | 56.3% |
| UnitedHealthcare | 30450 | facility | 50 | 1144.5 | 1701 | 4750 | 56.3% |
| UnitedHealthcare | 30465 | facility | 50 | 1144.5 | 1701 | 4750 | 56.3% |
| UnitedHealthcare | 30468 | facility | 50 | 1144.5 | 1701 | 4750 | 40.7% |
| UnitedHealthcare | 30469 | facility | 50 | 1144.5 | 1701 | 4750 | 42.1% |
| UnitedHealthcare | 30520 | facility | 50 | 781.75 | 929 | 2453.25 | 62.8% |
| UnitedHealthcare | 30801 | facility | 50 | 397.5 | 493 | 1214 | 74.8% |
| UnitedHealthcare | 30802 | facility | 50 | 397.5 | 493 | 1214 | 74.8% |
| UnitedHealthcare | 30903 | facility | 50 | 94 | 231.5 | 603 | 314.8% |
| UnitedHealthcare | 30905 | facility | 50 | 94 | 231.5 | 603 | 314.8% |
| UnitedHealthcare | 30906 | facility | 50 | 94 | 231.5 | 603 | 178.8% |
| UnitedHealthcare | 31231 | facility | 50 | 94 | 231.5 | 603 | 211% |
| UnitedHealthcare | 31237 | facility | 50 | 397.5 | 493 | 1260.5 | 58.5% |
| UnitedHealthcare | 31238 | facility | 50 | 397.5 | 493 | 1260.5 | 58.5% |
| UnitedHealthcare | 31239 | facility | 50 | 781.75 | 929 | 2453.25 | 54.8% |
| UnitedHealthcare | 31240 | facility | 50 | 781.75 | 929 | 2312.11 | 110.1% |
| UnitedHealthcare | 31253 | facility | 50 | 831 | 1364 | 3506.38 | 55.7% |
| UnitedHealthcare | 31254 | facility | 50 | 781.75 | 929 | 2453.25 | 37.9% |
| UnitedHealthcare | 31255 | facility | 50 | 831 | 1364 | 3506.38 | 55.7% |
| UnitedHealthcare | 31256 | facility | 50 | 781.75 | 929 | 2453.25 | 54.8% |
| UnitedHealthcare | 31257 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31259 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31267 | facility | 50 | 781.75 | 929 | 2453.25 | 37.9% |
| UnitedHealthcare | 31276 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31287 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31288 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31295 | facility | 50 | 831 | 1364 | 3506.38 | 44% |
| UnitedHealthcare | 31296 | facility | 50 | 831 | 1364 | 3068.2 | 91.2% |
| UnitedHealthcare | 31297 | facility | 50 | 781.75 | 929 | 2704.13 | 29.9% |
| UnitedHealthcare | 31298 | facility | 50 | 831 | 1364 | 3311.38 | 55.7% |
| UnitedHealthcare | 31535 | facility | 50 | 781.75 | 929 | 2398.25 | 54.8% |
| UnitedHealthcare | 31536 | facility | 50 | 781.75 | 929 | 2398.25 | 54.8% |
| UnitedHealthcare | 31540 | facility | 50 | 781.75 | 929 | 2398.25 | 54.8% |
| UnitedHealthcare | 31541 | facility | 50 | 781.75 | 929 | 2398.25 | 54.8% |
| UnitedHealthcare | 31575 | facility | 50 | 94 | 231.5 | 603 | 249.9% |
| UnitedHealthcare | 31576 | facility | 50 | 397.5 | 493 | 1214 | 58.5% |
| UnitedHealthcare | 31577 | facility | 50 | 94 | 231.5 | 603 | 107.8% |
| UnitedHealthcare | 31578 | facility | 50 | 397.5 | 493 | 1214 | 29.1% |
| UnitedHealthcare | 31579 | facility | 50 | 94 | 231.5 | 603 | 182.9% |
| UnitedHealthcare | 31600 | facility | 50 | 781.75 | 929 | 2398.25 | 62.8% |
| UnitedHealthcare | 32555 | facility | 50 | 316.25 | 395 | 1004 | 114.7% |
| UnitedHealthcare | 33206 | facility | 50 | 2183.75 | 5300 | 11610.32 | 72.8% |
| UnitedHealthcare | 33207 | facility | 50 | 2183.75 | 5300 | 11794.68 | 70.1% |
| UnitedHealthcare | 33208 | facility | 50 | 2189.75 | 6900 | 14627.5 | 89.2% |
| UnitedHealthcare | 33212 | facility | 50 | 2183.75 | 5300 | 10914.03 | 79.7% |
| UnitedHealthcare | 33213 | facility | 50 | 2183.75 | 4900 | 11573.12 | 63.8% |
| UnitedHealthcare | 33214 | facility | 50 | 2189.75 | 6900 | 13896.25 | 90.4% |
| UnitedHealthcare | 33216 | facility | 50 | 1421.75 | 2189 | 5491 | 37.1% |
| UnitedHealthcare | 33217 | facility | 50 | 1421.75 | 2189 | 5341.25 | 33.7% |
| UnitedHealthcare | 33224 | facility | 50 | 2189.75 | 6900 | 13221 | 89.6% |
| UnitedHealthcare | 33226 | facility | 50 | 831 | 1364 | 3311.38 | 63.3% |
| UnitedHealthcare | 33227 | facility | 50 | 2183.75 | 5986.5 | 10912.75 | 93% |
| UnitedHealthcare | 33228 | facility | 50 | 2183.75 | 5986.5 | 11693.05 | 79.3% |
| UnitedHealthcare | 33229 | facility | 50 | 2183.75 | 5300 | 12478.5 | 39.2% |
| UnitedHealthcare | 33230 | facility | 50 | 3200 | 17857.25 | 22595 | 94.4% |
| UnitedHealthcare | 33231 | facility | 50 | 3200 | 17857.25 | 22595 | 70.1% |
| UnitedHealthcare | 33240 | facility | 50 | 3200 | 17857.25 | 22595 | 96.1% |
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