What does uhc pay orthopedics groups in IL?
Median published rate is 100.2% of Medicare across 676 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 182 procedure codes and 1 payer, the median published rate is 154 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 154 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 676 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 | 676 | 87.75 | 97.23 | 119.19 | 100.2% |
| UnitedHealthcare | 99214 | professional | 638 | 131.84 | 151.44 | 177.27 | 107% |
| UnitedHealthcare | 99204 | professional | 539 | 224.49 | 254.54 | 278.55 | 134.7% |
| UnitedHealthcare | 99203 | professional | 525 | 130.05 | 147.53 | 173.95 | 119.3% |
| UnitedHealthcare | 20610 | professional | 473 | 88.41 | 102.7 | 112.76 | 140.5% |
| UnitedHealthcare | 73030 | professional | 306 | 17.44 | 32.14 | 46.5 | 148.3% |
| UnitedHealthcare | 73502 | professional | 293 | 20.21 | 47.91 | 65.97 | 147.7% |
| UnitedHealthcare | 73564 | professional | 266 | 20.68 | 46.01 | 63.18 | 144.7% |
| UnitedHealthcare | 73562 | professional | 256 | 18.14 | 41.77 | 57.11 | 146.9% |
| UnitedHealthcare | 27447 | professional | 241 | 2355.89 | 2632.78 | 3121.7 | 206% |
| UnitedHealthcare | 99212 | professional | 224 | 53.57 | 58.97 | 67.86 | 96.2% |
| UnitedHealthcare | 27130 | professional | 187 | 2357.51 | 2605.06 | 3028.24 | 204.1% |
| UnitedHealthcare | 72100 | professional | 147 | 19 | 37.87 | 55.94 | 145.7% |
| UnitedHealthcare | 73110 | professional | 145 | 14.95 | 42.34 | 56.57 | 140.2% |
| UnitedHealthcare | 20550 | professional | 136 | 75.32 | 88.78 | 96.32 | 139.8% |
| UnitedHealthcare | 73130 | professional | 133 | 16.18 | 37.15 | 49.31 | 149.7% |
| UnitedHealthcare | 73721 | professional | 131 | 112.04 | 245.53 | 347.56 | 166.5% |
| UnitedHealthcare | 20600 | professional | 117 | 67.59 | 82.27 | 92.52 | 142% |
| UnitedHealthcare | 73560 | professional | 115 | 15.08 | 35.64 | 49.32 | 154.3% |
| UnitedHealthcare | 20605 | professional | 114 | 71.32 | 78.75 | 92.33 | 138.1% |
| UnitedHealthcare | 73221 | professional | 110 | 114.74 | 245.52 | 348.06 | 165.7% |
| UnitedHealthcare | 20611 | professional | 108 | 121.95 | 143.82 | 149.57 | 130% |
| UnitedHealthcare | 73080 | professional | 103 | 16.18 | 35.64 | 49.86 | 156.4% |
| UnitedHealthcare | 99215 | professional | 100 | 202.15 | 231.34 | 243.88 | 112.9% |
| UnitedHealthcare | 64721 | professional | 93 | 727.7 | 867.04 | 927.62 | 165.1% |
| UnitedHealthcare | 72148 | professional | 93 | 140.6 | 249.25 | 328.35 | 173.4% |
| UnitedHealthcare | 73610 | professional | 91 | 15.68 | 37.14 | 50.43 | 148.2% |
| UnitedHealthcare | 23472 | professional | 89 | 2278.79 | 2774.15 | 3105.82 | 185.4% |
| UnitedHealthcare | 73630 | professional | 83 | 15.33 | 33.19 | 46.52 | 152.5% |
| UnitedHealthcare | 26055 | professional | 77 | 684.87 | 772.45 | 901.96 | 122% |
| UnitedHealthcare | 72040 | professional | 76 | 19.63 | 37.01 | 52.59 | 147.7% |
| UnitedHealthcare | 27245 | professional | 74 | 2137.73 | 2284.3 | 2658.24 | 184% |
| UnitedHealthcare | 72110 | professional | 67 | 24.68 | 52.36 | 68.93 | 146.8% |
| UnitedHealthcare | 29827 | professional | 63 | 1801.56 | 1983.83 | 2276.43 | 178.1% |
| UnitedHealthcare | 97110 | professional | 63 | 28.87 | 40.03 | 49.3 | 134.9% |
| UnitedHealthcare | 20526 | professional | 60 | 112.17 | 121.32 | 144.4 | 138.7% |
| UnitedHealthcare | 77002 | professional | 54 | 53.2 | 116.15 | 150.97 | 154.4% |
| UnitedHealthcare | 97140 | professional | 53 | 25.63 | 33.51 | 41.93 | 118.3% |
| UnitedHealthcare | 63047 | professional | 52 | 2004.99 | 2213.68 | 2387.63 | 166.3% |
| UnitedHealthcare | 29826 | professional | 50 | 310.29 | 356.82 | 412.4 | 217.4% |
| UnitedHealthcare | 73552 | professional | 46 | 16.84 | 36.76 | 52.08 | 156.8% |
| UnitedHealthcare | 99205 | professional | 46 | 327.43 | 359.18 | 377.34 | 142.1% |
| UnitedHealthcare | 22853 | professional | 45 | 489.12 | 548.34 | 563.02 | 190.7% |
| UnitedHealthcare | 72141 | professional | 45 | 142 | 222.01 | 329.37 | 180.9% |
| UnitedHealthcare | 29823 | professional | 42 | 1053.28 | 1264.99 | 1361.77 | 189.7% |
| UnitedHealthcare | 27236 | professional | 41 | 2041.17 | 2221.85 | 2440.4 | 173.3% |
| UnitedHealthcare | 22633 | professional | 39 | 3353.03 | 3547.41 | 3973.44 | 172.5% |
| UnitedHealthcare | 72070 | professional | 34 | 19.32 | 36.21 | 52.76 | 159.1% |
| UnitedHealthcare | 97530 | professional | 34 | 33.85 | 38.33 | 60.35 | 106.4% |
| UnitedHealthcare | 29828 | professional | 33 | 1556.57 | 1853.08 | 1958.78 | 169.1% |
| UnitedHealthcare | 29824 | professional | 31 | 1131.5 | 1241.63 | 1389.87 | 157.5% |
| UnitedHealthcare | 20610 | facility | 30 | 192.5 | 331 | 569.25 | 850% |
| UnitedHealthcare | 22842 | professional | 30 | 1417.2 | 1640.9 | 1733.37 | 191.5% |
| UnitedHealthcare | 25600 | professional | 30 | 525.32 | 552.93 | 673.81 | 165.3% |
| UnitedHealthcare | 20550 | facility | 29 | 212 | 362 | 570 | 1089.4% |
| UnitedHealthcare | 20600 | facility | 29 | 212 | 362 | 570 | 1123.5% |
| UnitedHealthcare | 63048 | professional | 29 | 393.65 | 450.18 | 467.93 | 193.4% |
| UnitedHealthcare | 73501 | professional | 29 | 18.55 | 31.89 | 45.26 | 160% |
| UnitedHealthcare | 92945 | facility | 29 | 567 | 750 | 1961 | 10.1% |
| UnitedHealthcare | 93452 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93454 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93455 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93456 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93457 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93458 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93459 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93460 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 93461 | facility | 29 | 2913 | 3570 | 4406 | 209% |
| UnitedHealthcare | 97112 | professional | 29 | 28.22 | 32.9 | 37.78 | 98.1% |
| UnitedHealthcare | 10005 | facility | 28 | 566 | 700 | 1123.75 | 180.2% |
| UnitedHealthcare | 10021 | facility | 28 | 218 | 381 | 572 | 600.6% |
| UnitedHealthcare | 11640 | facility | 28 | 566 | 700 | 1123.75 | 493% |
| UnitedHealthcare | 11641 | facility | 28 | 566 | 700 | 1123.75 | 441.8% |
| UnitedHealthcare | 11642 | facility | 28 | 566 | 700 | 1123.75 | 405.7% |
| UnitedHealthcare | 11643 | facility | 28 | 566 | 700 | 1123.75 | 365.9% |
| UnitedHealthcare | 14040 | facility | 28 | 886 | 1394.5 | 1752.5 | 123.6% |
| UnitedHealthcare | 14041 | facility | 28 | 886 | 1394.5 | 1752.5 | 123.6% |
| UnitedHealthcare | 14060 | facility | 28 | 886 | 1394.5 | 1752.5 | 123.6% |
| UnitedHealthcare | 14061 | facility | 28 | 886 | 1394.5 | 1752.5 | 123.6% |
| UnitedHealthcare | 15823 | facility | 28 | 886 | 1394.5 | 1752.5 | 123.6% |
| UnitedHealthcare | 19296 | facility | 28 | 3429.75 | 4175 | 4892.5 | 93.5% |
| UnitedHealthcare | 19298 | facility | 28 | 3429.75 | 4175 | 4892.5 | 72% |
| UnitedHealthcare | 20526 | facility | 28 | 218 | 381 | 572 | 732.3% |
| UnitedHealthcare | 20551 | facility | 28 | 218 | 381 | 572 | 1134.9% |
| UnitedHealthcare | 20552 | facility | 28 | 218 | 381 | 572 | 1351.1% |
| UnitedHealthcare | 20553 | facility | 28 | 218 | 381 | 572 | 1158.1% |
| UnitedHealthcare | 20604 | facility | 28 | 218 | 381 | 572 | 696.3% |
| UnitedHealthcare | 20605 | facility | 28 | 218 | 381 | 572 | 1170.2% |
| UnitedHealthcare | 20606 | facility | 28 | 566 | 700 | 1123.75 | 1212.3% |
| UnitedHealthcare | 20611 | facility | 28 | 218 | 381 | 572 | 594.3% |
| UnitedHealthcare | 20680 | facility | 28 | 1697.5 | 2183.5 | 2632.5 | 174.9% |
| UnitedHealthcare | 21315 | facility | 28 | 886 | 1394.5 | 1752.5 | 211.6% |
| UnitedHealthcare | 21320 | facility | 28 | 886 | 1394.5 | 1752.5 | 94.2% |
| UnitedHealthcare | 21555 | facility | 28 | 886 | 1394.5 | 1752.5 | 188% |
| UnitedHealthcare | 22510 | facility | 28 | 2104.75 | 2773.5 | 3425 | 168.7% |
| UnitedHealthcare | 22511 | facility | 28 | 2104.75 | 2773.5 | 3425 | 168.7% |
| UnitedHealthcare | 22513 | facility | 28 | 3429.75 | 4175 | 4892.5 | 113% |
| UnitedHealthcare | 22514 | facility | 28 | 3429.75 | 4422 | 4925 | 119.7% |
| UnitedHealthcare | 22551 | facility | 28 | 3429.75 | 4636 | 14063.25 | 51.3% |
| UnitedHealthcare | 22558 | facility | 28 | 4565 | 8605 | 14043.75 | 42.8% |
| UnitedHealthcare | 22600 | facility | 28 | 4565 | 8605 | 13675.25 | 65.7% |
| UnitedHealthcare | 22612 | facility | 28 | 3429.75 | 4422 | 4925 | 32.8% |
| UnitedHealthcare | 22630 | facility | 28 | 4565 | 8605 | 14043.75 | 41.3% |
| UnitedHealthcare | 22633 | facility | 28 | 3410.5 | 7632.5 | 16070 | 36.6% |
| UnitedHealthcare | 22800 | facility | 28 | 4565 | 8180 | 13559.5 | 60.7% |
| UnitedHealthcare | 22802 | facility | 28 | 4565 | 8180 | 13559.5 | 58.7% |
| UnitedHealthcare | 22804 | facility | 28 | 4565 | 8180 | 13559.5 | 58.7% |
| UnitedHealthcare | 22810 | facility | 28 | 4565 | 8180 | 13559.5 | 58.7% |
| UnitedHealthcare | 22812 | facility | 28 | 4565 | 8180 | 13559.5 | 58.7% |
| UnitedHealthcare | 22849 | facility | 28 | 4565 | 8180 | 13559.5 | 88.8% |
| UnitedHealthcare | 22850 | facility | 28 | 3429.75 | 4175 | 4892.5 | 113% |
| UnitedHealthcare | 22852 | facility | 28 | 3429.75 | 4175 | 4892.5 | 113% |
| UnitedHealthcare | 22855 | facility | 28 | 3429.75 | 4175 | 4892.5 | 113% |
| UnitedHealthcare | 22856 | facility | 28 | 3429.75 | 4484.5 | 11122.5 | 34.2% |
| UnitedHealthcare | 22861 | facility | 28 | 4565 | 8605 | 13675.25 | 73.6% |
| UnitedHealthcare | 23472 | facility | 28 | 5100 | 12044 | 15290 | 86.6% |
| UnitedHealthcare | 24500 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 24505 | facility | 28 | 218 | 381 | 572 | 43.7% |
| UnitedHealthcare | 25600 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 25605 | facility | 28 | 566 | 700 | 1123.75 | 80.2% |
| UnitedHealthcare | 25607 | facility | 28 | 3429.75 | 4422 | 4925 | 89% |
| UnitedHealthcare | 25608 | facility | 28 | 3429.75 | 4422 | 4925 | 88.8% |
| UnitedHealthcare | 25609 | facility | 28 | 3549.5 | 4484.5 | 5050.5 | 89.4% |
| UnitedHealthcare | 26055 | facility | 28 | 886 | 1394.5 | 1752.5 | 159.8% |
| UnitedHealthcare | 26160 | facility | 28 | 886 | 1394.5 | 1752.5 | 159.8% |
| UnitedHealthcare | 26600 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 27130 | facility | 28 | 6556.5 | 13054.5 | 16312.33 | 135.8% |
| UnitedHealthcare | 27134 | facility | 28 | 4912.5 | 12005.5 | 16046.11 | 128.8% |
| UnitedHealthcare | 27236 | facility | 28 | 3429.75 | 4175 | 4892.5 | 85.5% |
| UnitedHealthcare | 27245 | facility | 28 | 2884 | 3560.5 | 4125 | 73.7% |
| UnitedHealthcare | 27278 | facility | 28 | 4219 | 7471 | 12846 | 49.7% |
| UnitedHealthcare | 27279 | facility | 28 | 4565 | 8605 | 14291.25 | 59.3% |
| UnitedHealthcare | 27280 | facility | 28 | 4565 | 8605 | 13675.25 | 62.4% |
| UnitedHealthcare | 27446 | facility | 28 | 6556.5 | 13054.5 | 16046.11 | 141.7% |
| UnitedHealthcare | 27447 | facility | 28 | 6556.5 | 13054.5 | 16275.83 | 139% |
| UnitedHealthcare | 27486 | facility | 28 | 4565 | 8180 | 13605.25 | 120.2% |
| UnitedHealthcare | 27487 | facility | 28 | 4565 | 8180 | 13605.25 | 58.6% |
| UnitedHealthcare | 27750 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 27752 | facility | 28 | 886 | 1394.5 | 1752.5 | 159.8% |
| UnitedHealthcare | 27786 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 27808 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 27816 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 28470 | facility | 28 | 218 | 381 | 572 | 281.1% |
| UnitedHealthcare | 29515 | facility | 28 | 218 | 381 | 567.75 | 687.9% |
| UnitedHealthcare | 29540 | facility | 28 | 218 | 381 | 567.75 | 2640.4% |
| UnitedHealthcare | 29580 | facility | 28 | 218 | 381 | 567.75 | 886.7% |
| UnitedHealthcare | 29805 | facility | 28 | 2232.75 | 2880.5 | 3508.75 | 175.2% |
| UnitedHealthcare | 29806 | facility | 28 | 3695 | 4484.5 | 5100 | 121.4% |
| UnitedHealthcare | 29807 | facility | 28 | 3695 | 4484.5 | 5100 | 121.4% |
| UnitedHealthcare | 29819 | facility | 28 | 3695 | 4484.5 | 4925 | 272.7% |
| UnitedHealthcare | 29820 | facility | 28 | 3695 | 4484.5 | 5100 | 121.4% |
| UnitedHealthcare | 29821 | facility | 28 | 3695 | 4484.5 | 4925 | 272.7% |
| UnitedHealthcare | 29822 | facility | 28 | 2232.75 | 2880.5 | 3508.75 | 175.2% |
| UnitedHealthcare | 29823 | facility | 28 | 3695 | 4484.5 | 4925 | 272.7% |
| UnitedHealthcare | 29824 | facility | 28 | 3695 | 4484.5 | 4925 | 272.7% |
| UnitedHealthcare | 29825 | facility | 28 | 3695 | 4484.5 | 4925 | 272.7% |
| UnitedHealthcare | 29827 | facility | 28 | 3695 | 4484.5 | 5100 | 121.4% |
| UnitedHealthcare | 29828 | facility | 28 | 3695 | 4484.5 | 5100 | 121.4% |
| UnitedHealthcare | 29870 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29873 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29874 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29875 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29876 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29877 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29879 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29880 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29881 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29882 | facility | 28 | 2289.25 | 2895.5 | 3508.75 | 176.1% |
| UnitedHealthcare | 29888 | facility | 28 | 3650.75 | 4557.5 | 5658.5 | 94.6% |
| UnitedHealthcare | 29889 | facility | 28 | 3650.75 | 4557.5 | 5658.5 | 45.9% |
| UnitedHealthcare | 29891 | facility | 28 | 3549.5 | 4422 | 4925 | 268.9% |
| UnitedHealthcare | 29894 | facility | 28 | 2232.75 | 2773.5 | 3425 | 168.7% |
| UnitedHealthcare | 29895 | facility | 28 | 2232.75 | 2773.5 | 3425 | 168.7% |
| UnitedHealthcare | 29914 | facility | 28 | 3429.75 | 4422 | 5000 | 119.7% |
| UnitedHealthcare | 29915 | facility | 28 | 3429.75 | 4422 | 5000 | 119.7% |
| UnitedHealthcare | 29916 | facility | 28 | 3429.75 | 4422 | 5000 | 119.7% |
| UnitedHealthcare | 30115 | facility | 28 | 1697.5 | 2183.5 | 2632.5 | 147.5% |
| UnitedHealthcare | 30130 | facility | 28 | 1697.5 | 2183.5 | 2632.5 | 147.5% |
| UnitedHealthcare | 30140 | facility | 28 | 1697.5 | 2183.5 | 2632.5 | 147.5% |
| UnitedHealthcare | 30420 | facility | 28 | 2884 | 3560.5 | 4125 | 117.7% |
| UnitedHealthcare | 30450 | facility | 28 | 2884 | 3560.5 | 4125 | 117.7% |
| UnitedHealthcare | 30465 | facility | 28 | 2884 | 3560.5 | 4125 | 117.7% |
| UnitedHealthcare | 30468 | facility | 28 | 2884 | 3560.5 | 4125 | 85.1% |
| UnitedHealthcare | 30469 | facility | 28 | 2760.5 | 3534.5 | 3950 | 87.5% |
| UnitedHealthcare | 30520 | facility | 28 | 1697.5 | 2183.5 | 2632.5 | 147.5% |
| UnitedHealthcare | 30801 | facility | 28 | 886 | 1394.5 | 1752.5 | 211.6% |
| UnitedHealthcare | 30802 | facility | 28 | 886 | 1394.5 | 1752.5 | 211.6% |
| UnitedHealthcare | 30903 | facility | 28 | 218 | 381 | 567.75 | 518.1% |
| UnitedHealthcare | 30905 | facility | 28 | 218 | 381 | 567.75 | 518.1% |
| UnitedHealthcare | 30906 | facility | 28 | 218 | 381 | 572 | 294.2% |
| UnitedHealthcare | 31231 | facility | 28 | 218 | 381 | 567.75 | 347.2% |
| UnitedHealthcare | 31237 | facility | 28 | 886 | 1394.5 | 1752.5 | 165.3% |
| UnitedHealthcare | 31238 | facility | 28 | 886 | 1394.5 | 1752.5 | 165.3% |
| UnitedHealthcare | 31239 | facility | 28 | 1697.5 | 2215 | 2761.5 | 130.6% |
| UnitedHealthcare | 31240 | facility | 28 | 1697.5 | 2215 | 2736.75 | 262.5% |
| UnitedHealthcare | 31253 | facility | 28 | 2104.75 | 2773.5 | 3508.75 | 113.2% |
| UnitedHealthcare | 31254 | facility | 28 | 1697.5 | 2215 | 2761.5 | 90.4% |
| UnitedHealthcare | 31255 | facility | 28 | 2104.75 | 2773.5 | 3425 | 113.2% |
| UnitedHealthcare | 31256 | facility | 28 | 1697.5 | 2215 | 2761.5 | 130.6% |
| UnitedHealthcare | 31257 | facility | 28 | 2104.75 | 2773.5 | 3508.75 | 113.2% |
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