# What Insurers Pay: UMR

The price UMR has already agreed to pay each doctor, for the same procedure, summarised by state. Prices for one procedure can differ several-fold between two practices a few miles apart.

- procedures mapped: 100
- zip codes: 23,095
- states: 56
- providers: 2,027,229
- prices as of: 2026-10-01

Web page, with the maps: https://medicalpricetransparency.netlify.app/insurers/umr/

## Procedures

Each table gives the price in every state: providers, lowest, median and highest, and the median as a multiple of Medicare.

| Group | Procedure | Code | Price shown | Typical price vs Medicare | By state | Map |
|---|---|---|---|---|---|---|
| Cancer screening | Diagnostic mammogram, both breasts | 77066 | any setting, doctor's fee | 1.5x Medicare | [table](statemap_77066_US.md) | [map](statemap_77066_US.html), [by county](countymap_77066_US.html) |
| Cancer screening | Diagnostic mammogram, one breast | 77065 | any setting, doctor's fee | 1.5x Medicare | [table](statemap_77065_US.md) | [map](statemap_77065_US.html), [by county](countymap_77065_US.html) |
| Cancer screening | Screening colonoscopy (average risk) | G0121 | surgery center / hospital outpatient, doctor's fee | 1.8x Medicare | [table](statemap_G0121_US.md) | [map](statemap_G0121_US.html), [by county](countymap_G0121_US.html) |
| Cancer screening | Screening mammogram (routine) | 77067 | any setting, doctor's fee | 1.5x Medicare | [table](statemap_77067_US.md) | [map](statemap_77067_US.html), [by county](countymap_77067_US.html) |
| Digestive procedures | Colonoscopy (diagnostic) | 45378 | surgery center / hospital outpatient, doctor's fee | 1.8x Medicare | [table](statemap_45378_US.md) | [map](statemap_45378_US.html), [by county](countymap_45378_US.html) |
| Digestive procedures | Colonoscopy with biopsy | 45380 | surgery center / hospital outpatient, doctor's fee | 1.9x Medicare | [table](statemap_45380_US.md) | [map](statemap_45380_US.html), [by county](countymap_45380_US.html) |
| Digestive procedures | Colonoscopy with polyp removal | 45385 | surgery center / hospital outpatient, doctor's fee | 1.8x Medicare | [table](statemap_45385_US.md) | [map](statemap_45385_US.html), [by county](countymap_45385_US.html) |
| Digestive procedures | Colonoscopy with ultrasound | 45391 | surgery center / hospital outpatient, doctor's and facility fees | 1.9x Medicare | [table](statemap_45391_US.md) | [map](statemap_45391_US.html), [by county](countymap_45391_US.html) |
| Digestive procedures | Upper endoscopy (diagnostic) | 43235 | surgery center / hospital outpatient, doctor's fee | 1.8x Medicare | [table](statemap_43235_US.md) | [map](statemap_43235_US.html), [by county](countymap_43235_US.html) |
| Digestive procedures | Upper endoscopy with biopsy | 43239 | surgery center / hospital outpatient, doctor's fee | 1.8x Medicare | [table](statemap_43239_US.md) | [map](statemap_43239_US.html), [by county](countymap_43239_US.html) |
| Emergency & hospital | Emergency room visit (high complexity) | 99284 | emergency room, doctor's fee | 1.4x Medicare | [table](statemap_99284_US.md) | [map](statemap_99284_US.html), [by county](countymap_99284_US.html) |
| Emergency & hospital | Emergency room visit (low complexity) | 99282 | emergency room, doctor's fee | 1.4x Medicare | [table](statemap_99282_US.md) | [map](statemap_99282_US.html), [by county](countymap_99282_US.html) |
| Emergency & hospital | Emergency room visit (moderate complexity) | 99283 | emergency room, doctor's fee | 1.3x Medicare | [table](statemap_99283_US.md) | [map](statemap_99283_US.html), [by county](countymap_99283_US.html) |
| Emergency & hospital | Emergency room visit (most complex) | 99285 | emergency room, doctor's fee | 1.4x Medicare | [table](statemap_99285_US.md) | [map](statemap_99285_US.html), [by county](countymap_99285_US.html) |
| Emergency & hospital | Hospital bedside visit, high complexity (per day) | 99233 | hospital stay, doctor's fee | 1.3x Medicare | [table](statemap_99233_US.md) | [map](statemap_99233_US.html), [by county](countymap_99233_US.html) |
| Emergency & hospital | Hospital bedside visit, moderate (per day) | 99232 | hospital stay, doctor's fee | 1.3x Medicare | [table](statemap_99232_US.md) | [map](statemap_99232_US.html), [by county](countymap_99232_US.html) |
| Eye care | Cataract surgery with lens implant | 66984 | surgery center / hospital outpatient, doctor's and facility fees | 1.5x Medicare | [table](statemap_66984_US.md) | [map](statemap_66984_US.html), [by county](countymap_66984_US.html) |
| Eye care | Laser fix for cloudy vision after cataract surgery | 66821 | surgery center / hospital outpatient, doctor's fee | 1.2x Medicare | [table](statemap_66821_US.md) | [map](statemap_66821_US.html), [by county](countymap_66821_US.html) |
| Heart tests | Electrocardiogram (EKG) | 93000 | office, doctor's fee | 1.7x Medicare | [table](statemap_93000_US.md) | [map](statemap_93000_US.html), [by county](countymap_93000_US.html) |
| Heart tests | Heart catheterization (left heart) | 93452 | surgery center / hospital outpatient, doctor's fee | 1.4x Medicare | [table](statemap_93452_US.md) | [map](statemap_93452_US.html), [by county](countymap_93452_US.html) |
| Home health | Home health visit by a registered nurse (15 min) | G0299 | at home, doctor's fee |  | [table](statemap_G0299_US.md) | [map](statemap_G0299_US.html), [by county](countymap_G0299_US.html) |
| Hospital stays (inpatient) | Heart valve surgery with catheterization (hospital stay) | 216 | hospital stay, doctor's fee | 2.4x Medicare | [table](statemap_216_US.md) | [map](statemap_216_US.html), [by county](countymap_216_US.html) |
| Hospital stays (inpatient) | Hip or knee replacement (hospital stay) | 470 | hospital stay, doctor's and facility fees | 2.5x Medicare | [table](statemap_470_US.md) | [map](statemap_470_US.html), [by county](countymap_470_US.html) |
| Hospital stays (inpatient) | Neck spinal fusion (hospital stay) | 473 | hospital stay, doctor's and facility fees | 2.6x Medicare | [table](statemap_473_US.md) | [map](statemap_473_US.html), [by county](countymap_473_US.html) |
| Hospital stays (inpatient) | Spinal fusion, lower back (hospital stay) | 460 | hospital stay, facility fee | 1.7x Medicare | [table](statemap_460_US.md) | [map](statemap_460_US.html) |
| Hospital stays (inpatient) | Uterus or ovary surgery, non-cancer (hospital stay) | 743 | hospital stay, doctor's fee | 2.3x Medicare | [table](statemap_743_US.md) | [map](statemap_743_US.html), [by county](countymap_743_US.html) |
| Imaging & scans | Abdominal ultrasound (complete) | 76700 | any setting, doctor's fee | 1.4x Medicare | [table](statemap_76700_US.md) | [map](statemap_76700_US.html), [by county](countymap_76700_US.html) |
| Imaging & scans | CT scan of abdomen and pelvis (with dye) | 74177 | any setting, doctor's fee | 1.5x Medicare | [table](statemap_74177_US.md) | [map](statemap_74177_US.html), [by county](countymap_74177_US.html) |
| Imaging & scans | CT scan of the head (no dye) | 70450 | any setting, doctor's fee | 1.9x Medicare | [table](statemap_70450_US.md) | [map](statemap_70450_US.html), [by county](countymap_70450_US.html) |
| Imaging & scans | CT scan of the pelvis (with dye) | 72193 | any setting, doctor's fee | 1.6x Medicare | [table](statemap_72193_US.md) | [map](statemap_72193_US.html), [by county](countymap_72193_US.html) |
| Imaging & scans | Chest X-ray (single view) | 71045 | any setting, doctor's fee | 1.3x Medicare | [table](statemap_71045_US.md) | [map](statemap_71045_US.html), [by county](countymap_71045_US.html) |
| Imaging & scans | Chest X-ray (two views) | 71046 | any setting, doctor's fee | 1.2x Medicare | [table](statemap_71046_US.md) | [map](statemap_71046_US.html), [by county](countymap_71046_US.html) |
| Imaging & scans | Lower back X-ray (4+ views) | 72110 | any setting, doctor's fee | 1.2x Medicare | [table](statemap_72110_US.md) | [map](statemap_72110_US.html), [by county](countymap_72110_US.html) |
| Imaging & scans | MRI of a leg joint (no dye) | 73721 | any setting, doctor's fee | 1.9x Medicare | [table](statemap_73721_US.md) | [map](statemap_73721_US.html), [by county](countymap_73721_US.html) |
| Imaging & scans | MRI of the brain (no dye) | 70551 | any setting, doctor's fee | 2.0x Medicare | [table](statemap_70551_US.md) | [map](statemap_70551_US.html), [by county](countymap_70551_US.html) |
| Imaging & scans | MRI of the brain (with and without dye) | 70553 | any setting, doctor's fee | 2.0x Medicare | [table](statemap_70553_US.md) | [map](statemap_70553_US.html), [by county](countymap_70553_US.html) |
| Imaging & scans | MRI of the lower back (no dye) | 72148 | any setting, doctor's fee | 1.9x Medicare | [table](statemap_72148_US.md) | [map](statemap_72148_US.html), [by county](countymap_72148_US.html) |
| Labs & bloodwork | Basic metabolic panel (BMP) | 80048 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80048_US.md) | [map](statemap_80048_US.html), [by county](countymap_80048_US.html) |
| Labs & bloodwork | Basic urine test (automated) | 81003 | any setting, doctor's fee | about what Medicare pays | [table](statemap_81003_US.md) | [map](statemap_81003_US.html), [by county](countymap_81003_US.html) |
| Labs & bloodwork | Basic urine test (manual) | 81002 | any setting, doctor's fee | 0.8x Medicare | [table](statemap_81002_US.md) | [map](statemap_81002_US.html), [by county](countymap_81002_US.html) |
| Labs & bloodwork | Blood clotting test (PTT) | 85730 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_85730_US.md) | [map](statemap_85730_US.html), [by county](countymap_85730_US.html) |
| Labs & bloodwork | Blood clotting time test (PT/INR) | 85610 | any setting, doctor's fee | about what Medicare pays | [table](statemap_85610_US.md) | [map](statemap_85610_US.html), [by county](countymap_85610_US.html) |
| Labs & bloodwork | Blood draw | 36415 | office, doctor's fee | 0.3x Medicare | [table](statemap_36415_US.md) | [map](statemap_36415_US.html), [by county](countymap_36415_US.html) |
| Labs & bloodwork | Cholesterol test (lipid panel) | 80061 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80061_US.md) | [map](statemap_80061_US.html), [by county](countymap_80061_US.html) |
| Labs & bloodwork | Complete blood count (CBC, basic) | 85027 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_85027_US.md) | [map](statemap_85027_US.html), [by county](countymap_85027_US.html) |
| Labs & bloodwork | Complete blood count with differential (CBC) | 85025 | any setting, doctor's fee | 0.7x Medicare | [table](statemap_85025_US.md) | [map](statemap_85025_US.html), [by county](countymap_85025_US.html) |
| Labs & bloodwork | Comprehensive metabolic panel (CMP) | 80053 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80053_US.md) | [map](statemap_80053_US.html), [by county](countymap_80053_US.html) |
| Labs & bloodwork | Hemoglobin A1c (3-month blood sugar) | 83036 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_83036_US.md) | [map](statemap_83036_US.html), [by county](countymap_83036_US.html) |
| Labs & bloodwork | Kidney function panel | 80069 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80069_US.md) | [map](statemap_80069_US.html), [by county](countymap_80069_US.html) |
| Labs & bloodwork | Liver function panel | 80076 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80076_US.md) | [map](statemap_80076_US.html), [by county](countymap_80076_US.html) |
| Labs & bloodwork | PSA prostate blood test (free) | 84154 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_84154_US.md) | [map](statemap_84154_US.html), [by county](countymap_84154_US.html) |
| Labs & bloodwork | PSA prostate blood test (total) | 84153 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_84153_US.md) | [map](statemap_84153_US.html), [by county](countymap_84153_US.html) |
| Labs & bloodwork | Thyroid blood test (TSH) | 84443 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_84443_US.md) | [map](statemap_84443_US.html), [by county](countymap_84443_US.html) |
| Labs & bloodwork | Urine test with microscope (automated) | 81001 | any setting, doctor's fee | about what Medicare pays | [table](statemap_81001_US.md) | [map](statemap_81001_US.html), [by county](countymap_81001_US.html) |
| Labs & bloodwork | Urine test with microscope (manual) | 81000 | any setting, doctor's fee | 0.9x Medicare | [table](statemap_81000_US.md) | [map](statemap_81000_US.html), [by county](countymap_81000_US.html) |
| Mental health | Family or couples therapy (patient present) | 90847 | office, doctor's fee | 0.8x Medicare | [table](statemap_90847_US.md) | [map](statemap_90847_US.html), [by county](countymap_90847_US.html) |
| Mental health | Family therapy (without the patient present) | 90846 | office, doctor's fee | 0.9x Medicare | [table](statemap_90846_US.md) | [map](statemap_90846_US.html), [by county](countymap_90846_US.html) |
| Mental health | Group therapy session | 90853 | office, doctor's fee | 1.3x Medicare | [table](statemap_90853_US.md) | [map](statemap_90853_US.html), [by county](countymap_90853_US.html) |
| Mental health | Therapy session (30 minutes) | 90832 | office, doctor's fee | 0.7x Medicare | [table](statemap_90832_US.md) | [map](statemap_90832_US.html), [by county](countymap_90832_US.html) |
| Mental health | Therapy session (45 minutes) | 90834 | office, doctor's fee | 0.7x Medicare | [table](statemap_90834_US.md) | [map](statemap_90834_US.html), [by county](countymap_90834_US.html) |
| Mental health | Therapy session (60 minutes) | 90837 | office, doctor's fee | 0.7x Medicare | [table](statemap_90837_US.md) | [map](statemap_90837_US.html), [by county](countymap_90837_US.html) |
| Office visits | Office visit, existing patient (complex) | 99215 | office, doctor's fee | about what Medicare pays | [table](statemap_99215_US.md) | [map](statemap_99215_US.html), [by county](countymap_99215_US.html) |
| Office visits | Office visit, existing patient (extended) | 99214 | office, doctor's fee | 1.1x Medicare | [table](statemap_99214_US.md) | [map](statemap_99214_US.html), [by county](countymap_99214_US.html) |
| Office visits | Office visit, existing patient (short) | 99212 | office, doctor's fee | 1.1x Medicare | [table](statemap_99212_US.md) | [map](statemap_99212_US.html), [by county](countymap_99212_US.html) |
| Office visits | Office visit, existing patient (standard) | 99213 | office, doctor's fee | 1.1x Medicare | [table](statemap_99213_US.md) | [map](statemap_99213_US.html), [by county](countymap_99213_US.html) |
| Office visits | Office visit, new patient (complex) | 99205 | office, doctor's fee | 1.2x Medicare | [table](statemap_99205_US.md) | [map](statemap_99205_US.html), [by county](countymap_99205_US.html) |
| Office visits | Office visit, new patient (extended) | 99204 | office, doctor's fee | 1.3x Medicare | [table](statemap_99204_US.md) | [map](statemap_99204_US.html), [by county](countymap_99204_US.html) |
| Office visits | Office visit, new patient (short) | 99202 | office, doctor's fee | 1.3x Medicare | [table](statemap_99202_US.md) | [map](statemap_99202_US.html), [by county](countymap_99202_US.html) |
| Office visits | Office visit, new patient (standard) | 99203 | office, doctor's fee | 1.2x Medicare | [table](statemap_99203_US.md) | [map](statemap_99203_US.html), [by county](countymap_99203_US.html) |
| Office visits | Quick office visit, existing patient | 99211 | office, doctor's fee | 1.2x Medicare | [table](statemap_99211_US.md) | [map](statemap_99211_US.html), [by county](countymap_99211_US.html) |
| Office visits | Specialist consultation (extended) | 99244 | office, doctor's fee |  | [table](statemap_99244_US.md) | [map](statemap_99244_US.html), [by county](countymap_99244_US.html) |
| Office visits | Specialist consultation (standard) | 99243 | office, doctor's fee |  | [table](statemap_99243_US.md) | [map](statemap_99243_US.html), [by county](countymap_99243_US.html) |
| Other | Code 84484 | 84484 | any setting, doctor's fee |  | [table](statemap_84484_US.md) | [map](statemap_84484_US.html), [by county](countymap_84484_US.html) |
| Other | Code 93005 | 93005 | any setting, doctor's fee |  | [table](statemap_93005_US.md) | [map](statemap_93005_US.html), [by county](countymap_93005_US.html) |
| Preventive & wellness | Annual checkup, existing patient (age 18-39) | 99395 | office, doctor's fee |  | [table](statemap_99395_US.md) | [map](statemap_99395_US.html), [by county](countymap_99395_US.html) |
| Preventive & wellness | Annual checkup, existing patient (age 40-64) | 99396 | office, doctor's fee |  | [table](statemap_99396_US.md) | [map](statemap_99396_US.html), [by county](countymap_99396_US.html) |
| Preventive & wellness | Annual checkup, new patient (age 18-39) | 99385 | office, doctor's fee |  | [table](statemap_99385_US.md) | [map](statemap_99385_US.html), [by county](countymap_99385_US.html) |
| Preventive & wellness | Annual checkup, new patient (age 40-64) | 99386 | office, doctor's fee |  | [table](statemap_99386_US.md) | [map](statemap_99386_US.html), [by county](countymap_99386_US.html) |
| Sleep | Overnight sleep study (in a lab) | 95810 | any setting, doctor's fee | 1.4x Medicare | [table](statemap_95810_US.md) | [map](statemap_95810_US.html), [by county](countymap_95810_US.html) |
| Spine & pain injections | Epidural steroid injection, lower back (no imaging) | 62322 | surgery center / hospital outpatient, doctor's fee | 1.9x Medicare | [table](statemap_62322_US.md) | [map](statemap_62322_US.html), [by county](countymap_62322_US.html) |
| Spine & pain injections | Epidural steroid injection, lower back (with imaging) | 62323 | surgery center / hospital outpatient, doctor's fee | 1.7x Medicare | [table](statemap_62323_US.md) | [map](statemap_62323_US.html), [by county](countymap_62323_US.html) |
| Spine & pain injections | Nerve root steroid injection, lower back | 64483 | surgery center / hospital outpatient, doctor's fee | 1.5x Medicare | [table](statemap_64483_US.md) | [map](statemap_64483_US.html), [by county](countymap_64483_US.html) |
| Surgery & procedures | Breast lump removal (open surgery) | 19120 | surgery center / hospital outpatient, doctor's fee | 1.3x Medicare | [table](statemap_19120_US.md) | [map](statemap_19120_US.html), [by county](countymap_19120_US.html) |
| Surgery & procedures | Gallbladder removal (laparoscopic) | 47562 | surgery center / hospital outpatient, doctor's and facility fees | 1.8x Medicare | [table](statemap_47562_US.md) | [map](statemap_47562_US.html), [by county](countymap_47562_US.html) |
| Surgery & procedures | Groin hernia repair (age 5+) | 49505 | surgery center / hospital outpatient, doctor's and facility fees | 1.6x Medicare | [table](statemap_49505_US.md) | [map](statemap_49505_US.html), [by county](countymap_49505_US.html) |
| Surgery & procedures | Knee arthroscopy - torn cartilage trim | 29881 | surgery center / hospital outpatient, doctor's and facility fees | 1.6x Medicare | [table](statemap_29881_US.md) | [map](statemap_29881_US.html), [by county](countymap_29881_US.html) |
| Surgery & procedures | Prostate biopsy | 55700 | surgery center / hospital outpatient, doctor's fee |  | [table](statemap_55700_US.md) | [map](statemap_55700_US.html), [by county](countymap_55700_US.html) |
| Surgery & procedures | Prostate removal for cancer (laparoscopic) | 55866 | surgery center / hospital outpatient, doctor's and facility fees | 2.3x Medicare | [table](statemap_55866_US.md) | [map](statemap_55866_US.html), [by county](countymap_55866_US.html) |
| Surgery & procedures | Shoulder arthroscopy for impingement | 29826 | surgery center / hospital outpatient, doctor's and facility fees | 2.2x Medicare | [table](statemap_29826_US.md) | [map](statemap_29826_US.html), [by county](countymap_29826_US.html) |
| Surgery & procedures | Tonsil and adenoid removal (under 12) | 42820 | surgery center / hospital outpatient, doctor's and facility fees | 1.4x Medicare | [table](statemap_42820_US.md) | [map](statemap_42820_US.html), [by county](countymap_42820_US.html) |
| Therapy & rehab | Physical therapy - balance and coordination (15 min) | 97112 | office, doctor's fee | 1.1x Medicare | [table](statemap_97112_US.md) | [map](statemap_97112_US.html), [by county](countymap_97112_US.html) |
| Therapy & rehab | Physical therapy - functional activities (15 min) | 97530 | office, doctor's fee | 1.1x Medicare | [table](statemap_97530_US.md) | [map](statemap_97530_US.html), [by county](countymap_97530_US.html) |
| Therapy & rehab | Physical therapy - hands-on manual therapy (15 min) | 97140 | office, doctor's fee | about what Medicare pays | [table](statemap_97140_US.md) | [map](statemap_97140_US.html), [by county](countymap_97140_US.html) |
| Therapy & rehab | Physical therapy - therapeutic exercise (15 min) | 97110 | office, doctor's fee | 1.1x Medicare | [table](statemap_97110_US.md) | [map](statemap_97110_US.html), [by county](countymap_97110_US.html) |
| Women's health & maternity | C-section - full maternity care | 59510 | any setting, doctor's and facility fees | 1.2x Medicare | [table](statemap_59510_US.md) | [map](statemap_59510_US.html), [by county](countymap_59510_US.html) |
| Women's health & maternity | Pregnancy blood test panel | 80055 | any setting, doctor's fee | 0.6x Medicare | [table](statemap_80055_US.md) | [map](statemap_80055_US.html), [by county](countymap_80055_US.html) |
| Women's health & maternity | Pregnancy ultrasound (after 14 weeks) | 76805 | any setting, doctor's fee | 1.3x Medicare | [table](statemap_76805_US.md) | [map](statemap_76805_US.html), [by county](countymap_76805_US.html) |
| Women's health & maternity | Transvaginal pelvic ultrasound | 76830 | any setting, doctor's fee | 1.2x Medicare | [table](statemap_76830_US.md) | [map](statemap_76830_US.html), [by county](countymap_76830_US.html) |
| Women's health & maternity | Vaginal birth after cesarean - full maternity care | 59610 | any setting, doctor's and facility fees | 1.2x Medicare | [table](statemap_59610_US.md) | [map](statemap_59610_US.html), [by county](countymap_59610_US.html) |
| Women's health & maternity | Vaginal childbirth - full maternity care | 59400 | any setting, doctor's and facility fees | 1.2x Medicare | [table](statemap_59400_US.md) | [map](statemap_59400_US.html), [by county](countymap_59400_US.html) |

## About UMR

UMR is part of UnitedHealthcare, but it does not insure anyone. It runs health plans for employers that pay their employees' medical claims themselves - self-funded plans - and rents networks for them. So the prices here are what those employers pay: mostly through UnitedHealthcare's own networks (Choice Plus, Options PPO, Select Plus, Core, and its NexusACO and regional networks), plus some partner networks such as PHCS and HealthSmart.

Why it has a page of its own: who pays the bill. On a UnitedHealthcare insured plan, the insurer pays; on a UMR plan, the employer does. The contracted prices are the same where both use the same contract - in October 2026, 99.5% of the prices the two had in common were identical - but each carries contracts the other does not, so their maps differ.

Each price is listed under the network it belongs to, by the name on members' insurance cards. The names were read from UMR's file names, which give the employer and the network.

## What this data is

Since 2021, a federal rule called [Transparency in Coverage](https://www.federalregister.gov/documents/2020/11/12/2020-24591/transparency-in-coverage) has required health insurers to publish, **every month**, the rate they have negotiated with every provider in their network, for every billing code. Not an average, not a range — the actual contracted price, provider by provider.

The catch is that nobody can read them. They are published as raw JSON files running to gigabytes each, one per network, with providers referenced by numeric id rather than by name. They satisfy the rule without being of the slightest use to a patient. These maps are built directly from those files: every number here was published by the insurer, and nothing is estimated, modelled, or averaged from a survey.

## How this was built

UMR (a UnitedHealthcare company) publishes its files at [its price transparency page](https://transparency-in-coverage.uhc.com/). UMR publishes one file for each employer plan and network: 6,085 files, 89 TB, in October 2026. Nearly all of them repeat a few dozen underlying networks. Files whose provider lists are at least 95% alike were grouped into 69 families, and one file from each family was read. Four whole files from the largest family (4,558 files) held identical prices. This build downloaded **69 in-network rate files** (202.3 GB) on 2026-10-15.

From those, 150,139,414 price entries for 100 common procedures were extracted, each provider looked up in the federal NPPES registry for their practice address, and the results grouped by zip code.

**That is a count of entries, not of prices.** An entry is one price together with the list of providers it applies to, and insurers write their files very differently: some state a price once for a whole network, others repeat it for every practice. Here a typical UMR entry applies to 5 providers (50 on average), so the 150,139,414 entries come to about **7.6 billion provider-level prices** (counting each network file separately). A big or small entry count says how an insurer writes its files, not how many prices it has — compare insurers on the maps, not on this number.

## Check it yourself

Everything here is public and verifiable:

- [UMR’s own file index](https://transparency-in-coverage.uhc.com/) — the source these maps are built from
- [CMS: Health Plan Price Transparency](https://www.cms.gov/priorities/healthplan-price-transparency/health-plan-price-transparency) — the government programme behind the rule, and what insurers must publish
- [The rule itself](https://www.federalregister.gov/documents/2020/11/12/2020-24591/transparency-in-coverage) (Federal Register, 2020)
- [CMS's technical guide and file schemas](https://github.com/CMSgov/price-transparency-guide) — what is actually inside the files, if you want to read them yourself
- [Hospital prices](../../hospitals/) on this site — built from the files hospitals publish under a separate rule, with cash prices and every insurer's rate at each hospital

## What the price means

Each price is what this insurer pays that provider for that billing code — the price **in the setting where that procedure is normally done**: an office visit in an office, an emergency visit in the emergency department, a hospital stay as an inpatient, a colonoscopy at a surgery center or hospital outpatient department. Procedures done everywhere, such as lab tests and scans, show every in-person setting. Telehealth rates are excluded, and so are prices for only part of a service: a scan's reading fee or equipment fee alone, an assistant surgeon's fee, a procedure that was not completed. Each procedure below, and each map, says which setting it shows.

**It is not what you will be billed.** What you pay depends on your deductible, copay and coinsurance; a visit usually includes more than one billing code; and a hospital-based practice may add a facility fee. Use these maps to compare providers, not to predict a bill.

**“x Medicare”** compares each price with what original Medicare pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01). Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x. Across the 90 procedures below that Medicare prices, UMR’s typical price is **1.3x Medicare**; each procedure shows its own figure, and each map shows it state by state. Lab tests are compared with Medicare’s lab fee schedule and hospital stays with what Medicare paid hospitals in the state per stay; each map says which.

## Doctor’s fee or facility fee?

Care in a hospital or surgery center usually comes as **two separate bills**: the **doctor’s fee** (the “professional” fee, for the doctor’s own work) and the **facility fee** (the hospital or surgery center’s charge for the room, nurses and equipment). The facility fee is often the larger of the two, and many people do not know it is coming. A visit to an independent doctor’s office normally has no facility fee, but a clinic owned by a hospital may add one.

Insurers publish the two separately. **Every procedure below, and every map, says which one it shows**: here 86 show doctor's fee, 1 show facility fee, 13 show a mix of both.

## A whole visit, not one code

A visit is billed as several codes, each priced on its own. An emergency visit for chest pain is the visit code twice over (the doctor’s fee and the hospital’s facility fee), then blood tests, an EKG and a chest X-ray — and the tests vary more between hospitals than the visit code does. These are the typical totals UMR would pay in its largest states, adding up the median of each part; a part the files do not price there is left out and named.

- **ED visit with chest-pain workup**

- **Texas**: about **$263.98** (5 of 6 parts priced; without the facility fee for Emergency visit, level 4)
- **New York**: about **$301.41** (1 of 6 parts priced; without the facility fee for Emergency visit, level 4, Complete blood count, Comprehensive metabolic panel, the facility fee for Chest X-ray, two views, Troponin)
- **California**: about **$436.41** (5 of 6 parts priced; without the facility fee for Emergency visit, level 4)
- **Florida**: about **$249.02** (2 of 6 parts priced; without the facility fee for Emergency visit, level 4, Comprehensive metabolic panel, the facility fee for Chest X-ray, two views, Troponin)
- **Pennsylvania**: about **$333.64** (2 of 6 parts priced; without the facility fee for Emergency visit, level 4, Comprehensive metabolic panel, the facility fee for Chest X-ray, two views, Troponin)
- **Ohio**: about **$295.74** (4 of 6 parts priced; without the facility fee for Emergency visit, level 4, the facility fee for Chest X-ray, two views)

- **Vaginal delivery with a hospital stay**

- **California**: about **$2,667.52** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))
- **Texas**: about **$2,332.59** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))
- **Florida**: about **$2,325.00** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))
- **New York**: about **$2,939.11** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))
- **Pennsylvania**: about **$3,422.59** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))
- **Illinois**: about **$3,320.38** (1 of 2 parts priced; without Hospital stay for the delivery (MS-DRG 807, no complications; not yet on our code list))

- **Colonoscopy at a facility**

- **California**: about **$262.28** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)
- **Texas**: about **$239.42** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)
- **New York**: about **$232.99** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)
- **Florida**: about **$234.00** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)
- **Pennsylvania**: about **$305.65** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)
- **Illinois**: about **$348.25** (1 of 2 parts priced; without Surgery center or hospital outpatient facility fee for the same code)

## Who is counted

UMR lists clinicians individually: 89% of the 2,027,240 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. For each procedure, “providers” counts the clinicians whose specialty performs it, plus practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so their files name far more — family doctors and nurse practitioners listed at a price for a brain scan they will never do — and each map says how many were named.

## What this data may be missing

Some prices this insurer’s members pay are published somewhere else, so they are not on these maps:

- Prices found in only some copies of a network: these files repeat themselves heavily, so each group of nearly identical files was read once, through one of its files. Checks on the largest groups found their files share 98-100% of their prices; the rest, typically 1-2%, is not shown.
- Which employer: UMR's files are published employer by employer, but this site shows prices by network and state only, so no employer is named here.

## How the files read

UMR’s 0 index files name **69 in-network rate files** (dated 2026-10-01). **69 were downloaded and 69 read** — every one. 29 files held no prices for the procedures mapped here. The files also hold **38,706 price records in code sets this site does not read** (RC 24,201; ICD 11,062; CSTM-ALL 3,443) — revenue codes, dental codes and case-rate or bundled arrangements, where some of the highest-cost care (maternity, transplants, cancer treatment) can be contracted.

## What is not here

**These maps summarise a whole state.** Prices vary far more between two practices in one town than between two states, so a statewide median tells you what a procedure broadly costs, not what any particular provider charges. Zip-code and provider-level detail is not published here, but this data can be requested.

One insurer, one month, and only commercial plans — the rules do not cover Medicaid or Medicare Advantage, so those prices are not published at all. Out-of-network allowed amounts are published separately and are not included. Providers are placed at the practice address they registered with the federal NPI registry, which is sometimes a billing office rather than where they actually see patients.