What does uhc pay urology groups in TX?
Median published rate is 92% of Medicare across 550 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 192 procedure codes and 1 payer, the median published rate is 161 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare is the only payer with enough confirmed NPIs to publish here, at 161 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 550 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 | 550 | 109.77 | 128.34 | 134.51 | 92% |
| UnitedHealthcare | 99204 | professional | 522 | 167.18 | 187.7 | 208.47 | 107.8% |
| UnitedHealthcare | 99213 | professional | 505 | 74.98 | 83.77 | 90.32 | 87.9% |
| UnitedHealthcare | 52000 | professional | 495 | 178.73 | 213.93 | 254.5 | 98.7% |
| UnitedHealthcare | 51798 | professional | 437 | 15.12 | 18.5 | 23.2 | 149.8% |
| UnitedHealthcare | 76872 | professional | 282 | 51.02 | 111.72 | 168.12 | 142.8% |
| UnitedHealthcare | 99203 | professional | 249 | 107.27 | 129.11 | 146.66 | 105.5% |
| UnitedHealthcare | 99215 | professional | 206 | 144.11 | 162.9 | 189.24 | 85.1% |
| UnitedHealthcare | 51741 | professional | 199 | 9.91 | 15.81 | 25.78 | 149.4% |
| UnitedHealthcare | 52332 | professional | 175 | 318.51 | 422.55 | 528.2 | 126.5% |
| UnitedHealthcare | 96402 | professional | 145 | 36.94 | 41.2 | 48.18 | 108.1% |
| UnitedHealthcare | 52356 | professional | 139 | 499.99 | 581.51 | 692.12 | 170.5% |
| UnitedHealthcare | 99490 | professional | 136 | 43.16 | 43.4 | 45.04 | 66.5% |
| UnitedHealthcare | 51784 | professional | 126 | 55.97 | 90 | 127.09 | 177.3% |
| UnitedHealthcare | 96372 | professional | 123 | 18.7 | 22.95 | 29.72 | 148.4% |
| UnitedHealthcare | 51797 | professional | 107 | 71.31 | 156.22 | 223.77 | 157.1% |
| UnitedHealthcare | 99439 | professional | 106 | 40.52 | 41.03 | 41.36 | 81.6% |
| UnitedHealthcare | 51702 | professional | 105 | 57.01 | 64.65 | 75.45 | 101.8% |
| UnitedHealthcare | 99212 | professional | 98 | 41.46 | 50 | 55.28 | 83.1% |
| UnitedHealthcare | 51728 | professional | 93 | 183.24 | 349.04 | 485.41 | 155.9% |
| UnitedHealthcare | 52310 | professional | 88 | 251.57 | 320.84 | 375.52 | 106.9% |
| UnitedHealthcare | 99205 | professional | 85 | 216.5 | 268.74 | 455.19 | 114.1% |
| UnitedHealthcare | 76942 | professional | 84 | 37.31 | 61.48 | 102.73 | 147.1% |
| UnitedHealthcare | 76770 | professional | 81 | 52.92 | 85.36 | 120.74 | 124.7% |
| UnitedHealthcare | 52601 | professional | 61 | 1002.79 | 1101.55 | 1334.78 | 213% |
| UnitedHealthcare | 52287 | professional | 52 | 295.81 | 391.81 | 479.2 | 112% |
| UnitedHealthcare | 50590 | professional | 50 | 780.05 | 843.09 | 1179.85 | 107.6% |
| UnitedHealthcare | 51720 | professional | 37 | 111.35 | 116.01 | 190.12 | 130.5% |
| UnitedHealthcare | 51701 | professional | 36 | 45.72 | 51.08 | 53.38 | 113.4% |
| UnitedHealthcare | 76775 | professional | 35 | 31.03 | 45.19 | 62.43 | 118.7% |
| UnitedHealthcare | 55866 | professional | 33 | 1730.04 | 2241.82 | 2736.38 | 209% |
| UnitedHealthcare | 76857 | professional | 26 | 25.56 | 35.78 | 56.86 | 113.6% |
| UnitedHealthcare | 55874 | professional | 24 | 2318.5 | 2469.82 | 2729.9 | 67.6% |
| UnitedHealthcare | 64561 | professional | 24 | 774.08 | 799.23 | 814.03 | 110.4% |
| UnitedHealthcare | 52235 | professional | 18 | 367.07 | 545.31 | 800.67 | 212.3% |
| UnitedHealthcare | 52648 | professional | 18 | 1539.45 | 1559.6 | 1803.51 | 302.1% |
| UnitedHealthcare | 52649 | professional | 18 | 1210.48 | 1276.94 | 1313.34 | 195.5% |
| UnitedHealthcare | 64590 | professional | 18 | 319.47 | 323.88 | 334.69 | 77.2% |
| UnitedHealthcare | 52441 | professional | 17 | 858.91 | 896.25 | 1172.08 | 75.5% |
| UnitedHealthcare | 52442 | professional | 17 | 588.33 | 614.83 | 792.36 | 74.8% |
| UnitedHealthcare | 51729 | professional | 16 | 222.37 | 361.06 | 442.51 | 153.4% |
| UnitedHealthcare | 51703 | professional | 15 | 121.53 | 157.84 | 182.53 | 100.9% |
| UnitedHealthcare | 52224 | professional | 15 | 511.52 | 545.23 | 730.92 | 72.1% |
| UnitedHealthcare | 55706 | professional | 15 | 464.91 | 588.73 | 688.69 | 300.7% |
| UnitedHealthcare | 52281 | professional | 14 | 241.96 | 268.56 | 335.54 | 90% |
| UnitedHealthcare | 55876 | professional | 14 | 153.63 | 190.09 | 204.44 | 126.9% |
| UnitedHealthcare | 51715 | professional | 13 | 377.89 | 407.39 | 418.63 | 120.2% |
| UnitedHealthcare | 76856 | professional | 11 | 52.99 | 79.84 | 116.93 | 112.4% |
| UnitedHealthcare | 95971 | professional | 11 | 60.98 | 60.98 | 62.17 | 121.8% |
| UnitedHealthcare | 57288 | professional | 10 | 813.19 | 1108.87 | 1379.71 | 172.6% |
| UnitedHealthcare | 95972 | professional | 10 | 61.21 | 72.95 | 95.09 | 125.8% |
| UnitedHealthcare | 99202 | professional | 10 | 64.21 | 76.8 | 98.23 | 103.2% |
| UnitedHealthcare | 52005 | professional | 8 | 307.32 | 386.17 | 408.97 | 143.2% |
| UnitedHealthcare | 52240 | professional | 8 | 578.59 | 818.79 | 1056.96 | 236.6% |
| UnitedHealthcare | 10005 | facility | 7 | 859.5 | 1983 | 2960.5 | 510.4% |
| UnitedHealthcare | 10021 | facility | 7 | 483.5 | 1039 | 2450.5 | 1637.8% |
| UnitedHealthcare | 20526 | facility | 7 | 483.5 | 1039 | 2450.5 | 1996.9% |
| UnitedHealthcare | 20550 | facility | 7 | 483.5 | 1039 | 2450.5 | 3126.7% |
| UnitedHealthcare | 20551 | facility | 7 | 483.5 | 1039 | 2450.5 | 3095% |
| UnitedHealthcare | 20552 | facility | 7 | 483.5 | 1039 | 2450.5 | 3684.4% |
| UnitedHealthcare | 20553 | facility | 7 | 483.5 | 1039 | 2450.5 | 3158.1% |
| UnitedHealthcare | 20600 | facility | 7 | 483.5 | 1039 | 2450.5 | 3224.7% |
| UnitedHealthcare | 20604 | facility | 7 | 483.5 | 1039 | 2450.5 | 1898.8% |
| UnitedHealthcare | 20605 | facility | 7 | 483.5 | 1039 | 2450.5 | 3191% |
| UnitedHealthcare | 20606 | facility | 7 | 859.5 | 1983 | 2960.5 | 3434.4% |
| UnitedHealthcare | 20610 | facility | 7 | 483.5 | 1039 | 2450.5 | 2668.2% |
| UnitedHealthcare | 20611 | facility | 7 | 483.5 | 1039 | 2450.5 | 1620.7% |
| UnitedHealthcare | 21315 | facility | 7 | 1459.5 | 2416 | 3268 | 366.5% |
| UnitedHealthcare | 22510 | facility | 7 | 3647 | 5442 | 7112.25 | 330.8% |
| UnitedHealthcare | 22511 | facility | 7 | 3647 | 5442 | 7112.25 | 330.8% |
| UnitedHealthcare | 22513 | facility | 7 | 4856 | 5442 | 9033.25 | 147.3% |
| UnitedHealthcare | 22514 | facility | 7 | 4856 | 5442 | 9033.25 | 147.3% |
| UnitedHealthcare | 22551 | facility | 7 | 6713 | 8906 | 10594.25 | 98.6% |
| UnitedHealthcare | 22558 | facility | 7 | 5970 | 10635 | 12397 | 52.9% |
| UnitedHealthcare | 22600 | facility | 7 | 5970 | 10635 | 12397 | 81.2% |
| UnitedHealthcare | 22630 | facility | 7 | 5970 | 10635 | 12397 | 51% |
| UnitedHealthcare | 22633 | facility | 7 | 4485.5 | 9173 | 11438.5 | 44% |
| UnitedHealthcare | 22800 | facility | 7 | 5970 | 10635 | 12397 | 78.8% |
| UnitedHealthcare | 22802 | facility | 7 | 5970 | 10635 | 12397 | 76.3% |
| UnitedHealthcare | 22804 | facility | 7 | 5970 | 10635 | 12397 | 76.3% |
| UnitedHealthcare | 22810 | facility | 7 | 5970 | 10635 | 12397 | 76.3% |
| UnitedHealthcare | 22812 | facility | 7 | 5970 | 10635 | 12397 | 76.3% |
| UnitedHealthcare | 22849 | facility | 7 | 5970 | 10635 | 12397 | 115.4% |
| UnitedHealthcare | 22850 | facility | 7 | 5108 | 8906 | 10594.25 | 241% |
| UnitedHealthcare | 22852 | facility | 7 | 5108 | 8906 | 10594.25 | 241% |
| UnitedHealthcare | 22855 | facility | 7 | 5108 | 8906 | 10594.25 | 241% |
| UnitedHealthcare | 22856 | facility | 7 | 5108 | 8906 | 10594.25 | 68% |
| UnitedHealthcare | 22861 | facility | 7 | 5970 | 10635 | 12397 | 91% |
| UnitedHealthcare | 24500 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 24505 | facility | 7 | 483.5 | 1039 | 2450.5 | 119% |
| UnitedHealthcare | 25600 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 25605 | facility | 7 | 859.5 | 1983 | 2960.5 | 227.2% |
| UnitedHealthcare | 26600 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 27130 | facility | 7 | 11344.5 | 12714 | 15778.75 | 132.2% |
| UnitedHealthcare | 27134 | facility | 7 | 11344.5 | 12714 | 15778.75 | 136.3% |
| UnitedHealthcare | 27236 | facility | 7 | 5108 | 8906 | 9269.25 | 182.4% |
| UnitedHealthcare | 27278 | facility | 7 | 5970 | 10635 | 12397 | 70.7% |
| UnitedHealthcare | 27279 | facility | 7 | 5970 | 10635 | 12397 | 73.3% |
| UnitedHealthcare | 27280 | facility | 7 | 5970 | 10635 | 12397 | 77% |
| UnitedHealthcare | 27447 | facility | 7 | 11079.5 | 12714 | 15778.75 | 135.4% |
| UnitedHealthcare | 27486 | facility | 7 | 9289 | 12714 | 15778.75 | 186.8% |
| UnitedHealthcare | 27487 | facility | 7 | 9289 | 12714 | 15778.75 | 91% |
| UnitedHealthcare | 27750 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 27752 | facility | 7 | 1459.5 | 2416 | 3268 | 276.8% |
| UnitedHealthcare | 27786 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 27808 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 27816 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 28470 | facility | 7 | 483.5 | 1039 | 2450.5 | 766.6% |
| UnitedHealthcare | 29515 | facility | 7 | 483.5 | 1039 | 2450.5 | 1875.8% |
| UnitedHealthcare | 29540 | facility | 7 | 483.5 | 1039 | 2450.5 | 7200.3% |
| UnitedHealthcare | 29580 | facility | 7 | 483.5 | 1039 | 2450.5 | 2418% |
| UnitedHealthcare | 29914 | facility | 7 | 5108 | 7735 | 9033.25 | 209.3% |
| UnitedHealthcare | 29915 | facility | 7 | 5108 | 7735 | 9033.25 | 209.3% |
| UnitedHealthcare | 29916 | facility | 7 | 5108 | 7735 | 9033.25 | 209.3% |
| UnitedHealthcare | 30468 | facility | 7 | 4513.5 | 8140 | 8561.5 | 194.4% |
| UnitedHealthcare | 30469 | facility | 7 | 4513.5 | 8140 | 8561.5 | 201.4% |
| UnitedHealthcare | 30903 | facility | 7 | 483.5 | 1039 | 2450.5 | 1412.8% |
| UnitedHealthcare | 30905 | facility | 7 | 483.5 | 1039 | 2450.5 | 1412.8% |
| UnitedHealthcare | 30906 | facility | 7 | 483.5 | 1039 | 2450.5 | 802.3% |
| UnitedHealthcare | 31231 | facility | 7 | 483.5 | 1039 | 2450.5 | 946.9% |
| UnitedHealthcare | 31253 | facility | 7 | 3522 | 5442 | 7112.25 | 222% |
| UnitedHealthcare | 31257 | facility | 7 | 3522 | 5442 | 7112.25 | 222% |
| UnitedHealthcare | 31259 | facility | 7 | 3522 | 5442 | 7112.25 | 222% |
| UnitedHealthcare | 31295 | facility | 7 | 3522 | 5442 | 7112.25 | 175.2% |
| UnitedHealthcare | 31296 | facility | 7 | 3522 | 5442 | 7112.25 | 363.7% |
| UnitedHealthcare | 31297 | facility | 7 | 2883 | 4688 | 5579.25 | 150.6% |
| UnitedHealthcare | 31298 | facility | 7 | 3899 | 6300 | 7112.25 | 257% |
| UnitedHealthcare | 31575 | facility | 7 | 483.5 | 1039 | 2450.5 | 1121.4% |
| UnitedHealthcare | 32555 | facility | 7 | 859.5 | 1983 | 2960.5 | 575.5% |
| UnitedHealthcare | 33227 | facility | 7 | 5970 | 10635 | 12397 | 165.3% |
| UnitedHealthcare | 33228 | facility | 7 | 5970 | 10635 | 12397 | 140.8% |
| UnitedHealthcare | 33229 | facility | 7 | 5970 | 10635 | 12397 | 78.6% |
| UnitedHealthcare | 33230 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 94.1% |
| UnitedHealthcare | 33231 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 69.9% |
| UnitedHealthcare | 33262 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 94.2% |
| UnitedHealthcare | 33263 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 94% |
| UnitedHealthcare | 33264 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 71.5% |
| UnitedHealthcare | 33270 | facility | 7 | 13231.5 | 17815.5 | 36479.5 | 70.8% |
| UnitedHealthcare | 33271 | facility | 7 | 5970 | 10635 | 12397 | 136% |
| UnitedHealthcare | 33273 | facility | 7 | 3899 | 6300 | 7112.25 | 301.1% |
| UnitedHealthcare | 33274 | facility | 7 | 6149.5 | 7769 | 18794 | 54.6% |
| UnitedHealthcare | 33275 | facility | 7 | 3899 | 6300 | 7112.25 | 247.2% |
| UnitedHealthcare | 36573 | facility | 7 | 1459.5 | 2416 | 3268 | 371.7% |
| UnitedHealthcare | 36593 | facility | 7 | 483.5 | 1039 | 2450.5 | 2763.3% |
| UnitedHealthcare | 36598 | facility | 7 | 483.5 | 1039 | 2450.5 | 1150.6% |
| UnitedHealthcare | 37254 | facility | 7 | 5108 | 8906 | 9269.25 | 248.3% |
| UnitedHealthcare | 37256 | facility | 7 | 5108 | 8906 | 9269.25 | 248.3% |
| UnitedHealthcare | 37258 | facility | 7 | 5970 | 10635 | 12397 | 138.7% |
| UnitedHealthcare | 37260 | facility | 7 | 5970 | 10635 | 12397 | 138.7% |
| UnitedHealthcare | 37263 | facility | 7 | 5108 | 8906 | 9269.25 | 234.6% |
| UnitedHealthcare | 37265 | facility | 7 | 5108 | 8906 | 9269.25 | 234.6% |
| UnitedHealthcare | 37267 | facility | 7 | 5970 | 10635 | 12397 | 131.9% |
| UnitedHealthcare | 37269 | facility | 7 | 5970 | 10635 | 12397 | 131.9% |
| UnitedHealthcare | 37271 | facility | 7 | 5970 | 10635 | 12397 | 81.2% |
| UnitedHealthcare | 37273 | facility | 7 | 5970 | 10635 | 12397 | 81.2% |
| UnitedHealthcare | 37275 | facility | 7 | 5970 | 10635 | 12397 | 80.5% |
| UnitedHealthcare | 37277 | facility | 7 | 5970 | 10635 | 12397 | 80.5% |
| UnitedHealthcare | 37280 | facility | 7 | 5970 | 10635 | 12397 | 150.3% |
| UnitedHealthcare | 37282 | facility | 7 | 5970 | 10635 | 12397 | 150.3% |
| UnitedHealthcare | 37284 | facility | 7 | 5970 | 10635 | 12397 | 87.1% |
| UnitedHealthcare | 37286 | facility | 7 | 5970 | 10635 | 12397 | 87.1% |
| UnitedHealthcare | 37288 | facility | 7 | 5970 | 10635 | 12397 | 86% |
| UnitedHealthcare | 37290 | facility | 7 | 5970 | 10635 | 12397 | 86% |
| UnitedHealthcare | 37296 | facility | 7 | 5970 | 10635 | 12397 | 150.3% |
| UnitedHealthcare | 37298 | facility | 7 | 5970 | 10635 | 12397 | 150.3% |
| UnitedHealthcare | 38220 | facility | 7 | 859.5 | 1983 | 2960.5 | 1567% |
| UnitedHealthcare | 38221 | facility | 7 | 859.5 | 1983 | 2960.5 | 1618.5% |
| UnitedHealthcare | 38222 | facility | 7 | 1459.5 | 2416 | 3268 | 193.5% |
| UnitedHealthcare | 40808 | facility | 7 | 483.5 | 1039 | 2450.5 | 799.8% |
| UnitedHealthcare | 41530 | facility | 7 | 2883 | 4433 | 5579.25 | 558.2% |
| UnitedHealthcare | 43229 | facility | 7 | 2883 | 4433 | 5579.25 | 153% |
| UnitedHealthcare | 43266 | facility | 7 | 3899 | 6300 | 7112.25 | 144.7% |
| UnitedHealthcare | 43270 | facility | 7 | 1459.5 | 2416 | 3268 | 201.2% |
| UnitedHealthcare | 43274 | facility | 7 | 2883 | 4433 | 5579.25 | 119.6% |
| UnitedHealthcare | 43275 | facility | 7 | 1459.5 | 2416 | 3268 | 270.1% |
| UnitedHealthcare | 43276 | facility | 7 | 2883 | 4433 | 5579.25 | 119.5% |
| UnitedHealthcare | 43277 | facility | 7 | 2883 | 4433 | 5579.25 | 223.2% |
| UnitedHealthcare | 43762 | facility | 7 | 483.5 | 1039 | 2450.5 | 754% |
| UnitedHealthcare | 43763 | facility | 7 | 483.5 | 1039 | 2450.5 | 754% |
| UnitedHealthcare | 45388 | facility | 7 | 1459.5 | 2416 | 3268 | 367.9% |
| UnitedHealthcare | 45389 | facility | 7 | 1459.5 | 2416 | 3268 | 54.1% |
| UnitedHealthcare | 45390 | facility | 7 | 1459.5 | 2416 | 3268 | 168.7% |
| UnitedHealthcare | 45398 | facility | 7 | 1459.5 | 2416 | 3268 | 367.9% |
| UnitedHealthcare | 49083 | facility | 7 | 1459.5 | 2416 | 3268 | 485.3% |
| UnitedHealthcare | 50081 | professional | 7 | 2051.7 | 2339.81 | 3689.4 | 238.4% |
| UnitedHealthcare | 51703 | facility | 7 | 483.5 | 1039 | 2450.5 | 1396.9% |
| UnitedHealthcare | 51720 | facility | 7 | 483.5 | 1039 | 2450.5 | 1729.1% |
| UnitedHealthcare | 51725 | facility | 7 | 483.5 | 1039 | 2450.5 | 850.3% |
| UnitedHealthcare | 51727 | facility | 7 | 859.5 | 1983 | 2960.5 | 879.1% |
| UnitedHealthcare | 51728 | facility | 7 | 859.5 | 1983 | 2960.5 | 850% |
| UnitedHealthcare | 51729 | facility | 7 | 859.5 | 1983 | 2960.5 | 868.7% |
| UnitedHealthcare | 51784 | facility | 7 | 483.5 | 1039 | 2450.5 | 3558.2% |
| UnitedHealthcare | 51785 | facility | 7 | 483.5 | 1039 | 2450.5 | 754% |
| UnitedHealthcare | 52234 | professional | 7 | 427.55 | 484.32 | 487.54 | 217.6% |
| UnitedHealthcare | 52287 | facility | 7 | 1459.5 | 2416 | 3268 | 241.1% |
| UnitedHealthcare | 52352 | professional | 7 | 495.51 | 584.9 | 764.14 | 191.4% |
| UnitedHealthcare | 52356 | facility | 7 | 4513.5 | 6903 | 8561.5 | 252.9% |
| UnitedHealthcare | 53621 | facility | 7 | 483.5 | 1039 | 2450.5 | 881.9% |
| UnitedHealthcare | 53854 | facility | 7 | 2883 | 4433 | 5579.25 | 257.3% |
| UnitedHealthcare | 55706 | facility | 7 | 1459.5 | 2416 | 3268 | 140.2% |
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