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Official sources linked below

Negotiating with United: Fee Schedule and Reimbursement Rate Benchmarks for 2026

UnitedHealthcare operates employer and individual health benefits, Medicare and retirement products, and Medicaid-focused Community & State plans. Those lines of business use different products, networks, and contracting arrangements. PayerPrice structures the published United rate records it tracks so contract teams can compare the same plan, market, and provider type.

UHC

UnitedHealthcare

Employer, individual, Medicare, and Medicaid coverage

Plans tracked

Providers (NPIs)

Rate observations

MRF publication cadence

Monthly

Last refresh

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United Overview

UnitedHealthcare, at a glance

UnitedHealthcare operates employer and individual health benefits, Medicare and retirement products, and Medicaid-focused Community & State plans. Those lines of business use different products, networks, and contracting arrangements.

Compare rates from the same UnitedHealthcare business line, network, and market. A national average can provide context, but the provider agreement determines the applicable rate.

Payer sources

UnitedHealthcare business overview

United reimbursement can vary by product, network, provider contract, service details, and geographic location. Match those attributes before relying on a parent-brand benchmark.

Quick Facts

OFFICIAL PAYER + PAYERPRICE DATA

Payer TypeNational health benefits business
Total Membership
Market Share
Plan Types
Employer & Individual
Medicare & Retirement
Medicaid
Plans Tracked in PayerPrice
Data SourceMachine Readable Files (TiC Rule)
Data FreshnessUpdated monthly

Negotiation Playbook

How to negotiate better United reimbursement rates

Use these four steps to check the current contract, choose comparable rates, and prepare a specific proposal for United.

Step 1

Benchmark your current rates

Start with the executed contract and recent remittances. Confirm which rates are in use before comparing them with published data.

Step 2

Prioritize material services

Use paid claims to find the services that matter most financially. The priority list should reflect your practice, not an arbitrary number of codes.

Step 3

Build a comparable peer set

Compare published rates from the same plan and market for similar providers. Use them as context; they do not prove what another provider was paid on a specific claim.

Step 4

Build the negotiation case

Show the current terms, matched benchmarks, expected financial effect, and proposed rates. Spell out any assumptions.

Build a proposal the payer can evaluate.

Match published rates to the contract's network and market, then apply your own service mix to estimate the financial effect.

See our full payer contract negotiations guide for the deep dive.

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Reimbursement Rates · National Avg.

United rates for commonly billed CPT codes

These national-average in-network rates come from the latest available PayerPrice dataset. The table also shows the Medicare allowed amount for each selected CPT code. The provider contract and claim details determine the actual reimbursement.

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CPTDescriptionCategoryUnited National Avg.Medicare Benchmark
99214Office Visit, Established (Moderate)

E&M

View rates
99213Office Visit, Established (Low)

E&M

View rates
99215Office Visit, Established (High)

E&M

View rates
90837Psychotherapy, 60 min

Psychiatry

View rates
90834Psychotherapy, 45 min

Psychiatry

View rates
90791Psychiatric Diagnostic Evaluation

Psychiatry

View rates
70450CT Head/Brain without Contrast

Radiology

View rates
73721MRI Lower Extremity Joint

Radiology

View rates
45378Diagnostic Colonoscopy

Surgery

View rates

Rates shown are national averages. Actual United reimbursement varies by affiliate, plan, geographic location, and provider contract. For provider-level detail by NPI or Tax ID, run a free sample report.

United Machine Readable Files

How to read United machine-readable files

Under the Transparency in Coverage requirements, most non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual coverage must publish machine-readable files with in-network negotiated rates and out-of-network allowed amounts and billed charges. See the CMS guidance for plans and issuers. CMS's technical clarification states that the files are updated monthly.

PayerPrice makes the United records it tracks searchable by billing code, provider, plan, and market.

Search United rates without opening raw files
united_in-network-rates_example.jsonILLUSTRATIVE
1{
2 "reporting_entity_name": "UnitedHealthcare",
3 "plan_name": "United PPO",
4 "version": "1.3.0",
5 "in_network": [
6 { "billing_code": "99214",
7 "negotiated_rates": [
8 { "npi": 1538156793,
9 "negotiated_price": 162.84, "service_code": "11"
10 "billing_class": "professional" },
11 { "npi": 1972658421,
12 "negotiated_price": 148.20, "service_code": "11" },
13 // additional negotiated-rate rows
14 ]
15 },
16 // additional billing codes
17 ]
18}

rate observations in latest dataset

Frequently asked

Common questions about United fee schedules

A United fee schedule sets reimbursement terms for covered services in a provider agreement. The contract may use code-based prices or another payment method. PayerPrice organizes the published United rate records it tracks for comparison.

For United contract leads

Compare published United rates for similar providers.

Start with a sample of published United rate data, then narrow the comparison by plan, market, billing code, and provider attributes.

Your sample includes

Published rate records from United

CPT and Medicare comparisons, where available

Filters for plan, market, and provider

Guidance for reading machine-readable files