Nephrology reimbursement rates in Indiana
What UnitedHealthcare and Cigna have actually negotiated for the codes a nephrology practice bills in Indiana, taken from the payers’ own federal Transparency in Coverage filings and compared against Medicare.
3 of these 4 codes pay below Medicare in Indiana even at the best published rate. If your contract sits under these figures, the gap is contractual rather than a billing problem, and no amount of clean claims closes it.
| CPT | UnitedHealthcare | Cigna | Medicare | Best vs Medicare |
|---|---|---|---|---|
| 99215 | $148.33 | $176.21 | $182.08 | 97% |
| 99214 | $109.22 | $110.48 | $128.33 | 86% |
| 99213 | $74.59 | $76.00 | $90.09 | 84% |
| 99291 | $280.02 | $304.63 | $290.60 | 105% |
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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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 Indiana sit above the figures shown and half below, and where you fall depends on your group size and what you signed.