Gastroenterology reimbursement rates in Pennsylvania
What UnitedHealthcare and Cigna have actually negotiated for the codes a gastroenterology practice bills in Pennsylvania, taken from the payers’ own federal Transparency in Coverage filings and compared against Medicare.
| CPT | UnitedHealthcare | Cigna | Medicare | Best vs Medicare |
|---|---|---|---|---|
| 45381 | $477.92 | $569.99 | $484.95 | 118% |
| 45378 | $391.56 | $457.35 | $374.71 | 122% |
| 45380 | $481.41 | $563.12 | $474.81 | 119% |
Median negotiated rate per code, office place of service. A published rate is a benchmark, not a guarantee of your rate. Method at our rates methodology.
Work out what the gap costs you per year
Enter what you are paid and your monthly volume, and the calculator returns the annual difference against these published figures.
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Other specialties in Pennsylvania
These are negotiated rates, not payments. What reaches your account also depends on eligibility, medical necessity, bundling edits and whether the claim survives adjudication. Half the negotiated rates in Pennsylvania sit above the figures shown and half below, and where you fall depends on your group size and what you signed.