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Sample report: real insurer names, invented dollar figures.

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Your local rates report

An insurer-by-insurer look at your local market, from the insurers' published rates.

Prepared for
Carl Rogers, PMHNP-BC
Market
Raleigh, NC
ZIP code
27601
Report date
July 30, 2026
Peers
109 psychiatric NPs

The lay of the land, at a glance.

Four numbers that describe the market for psychiatric NPs in the Raleigh, NC area.

Billing CodeOffice visit, established patient, moderate complexity
psychiatric NPs in your area
109
In-network across major commercial payers in the Raleigh, NC area.
Median insurer rate (99214)
$140
Half the insurers near you pay more than this per session, half less.
Highest-paying insurer
BCBS North Carolina
Median 99214 rate $158, about 13% above the area median.
Rate spread
$27
BCBS North Carolina ($158) pays $27 more per session than Ambetter (Centene) ($131) .

Insurers included in this report.

Every insurer in your area, including those with too little local data to compare.

Included
6
Aetna, Ambetter (Centene), BCBS North Carolina, Cigna, MedCost, UnitedHealthcare (includes Oscar Health)
Limited data
None
Every insurer here has enough local peers to publish.
Not included
1

No data yet for Humana. Details on our insurers page.

Oscar Health uses the UnitedHealthcare (Optum Behavioral Health) network, so its rates appear under UnitedHealthcare (Optum Behavioral Health).

What insurers typically pay psychiatric NPs per session, in the Raleigh, NC area.

Every insurer’s 99214 rates for psychiatric NPs near you, pooled.

Billing CodeOffice visit, established patient, moderate complexity
Providers at the same rate1×10×25×40+
Peer rate dot plot for CPT 99214Each dot is one psychiatric NP's published rate; the shaded band is the middle half, the line its median. Bigger dots are several providers at one rate. 45 rates across 6 insurers.Across allcommercial payersN = 45MEDIAN $147Typical rates$100$125$150$175$200
Peer rate dot plot for CPT 99214
PayerRateMarker
Across all commercial payers$147median
Across all commercial payers$172p75
Across all commercial payers$93
Across all commercial payers$98
Across all commercial payers$103
Across all commercial payers$107
Across all commercial payers$109
Across all commercial payers$113
Across all commercial payers$116
Across all commercial payers$120
Across all commercial payers$122
Across all commercial payers$122
Across all commercial payers$127
Across all commercial payers$128
Across all commercial payers$129
Across all commercial payers$132
Across all commercial payers$133
Across all commercial payers$135
Across all commercial payers$136
Across all commercial payers$139
Across all commercial payers$140
Across all commercial payers$142
Across all commercial payers$143
Across all commercial payers$144
Across all commercial payers$147
Across all commercial payers$149
Across all commercial payers$150
Across all commercial payers$152
Across all commercial payers$155
Across all commercial payers$159
Across all commercial payers$160
Across all commercial payers$161
Across all commercial payers$163
Across all commercial payers$165
Across all commercial payers$169
Across all commercial payers$172
Across all commercial payers$175
Across all commercial payers$176
Across all commercial payers$180
Across all commercial payers$182
Across all commercial payers$186
Across all commercial payers$188
Across all commercial payers$192
Across all commercial payers$197
Across all commercial payers$203
Across all commercial payers$208
Across all commercial payers$218

Each dot is one psychiatric NP's published rate; the shaded band is the middle half, the line its median.

More info
Bigger dots are several providers at one rate. 45 rates across 6 insurers. The band is a reasonable range to expect before you apply; where any one insurer lands within it varies.

Each insurer, sized and placed.

Each insurer in the Raleigh, NC area, placed by its median psychiatric NPs rate and by how many people it covers per local provider.

Panel opportunity map

Psychiatric NPs · Raleigh, NC · CPT 99214

X-axis
Billing CodeOffice visit, established patient, moderate complexity
  • Above the area median
  • Near the median
  • Below the median
  • Well below
  • Bubble size = estimated covered lives

5 insurers in this metro for psychiatric NPs on CPT 99214. The average of their medians is $140 per session. 2 pay above it, 3 at or below.

Tabular view of the Panel Opportunity Map. Rows are insurers; columns are rate, members per local provider, and the number of local peers behind each insurer's stats. Estimated covered lives for this insurer in your area, per active provider in your specialty practising there: everyone available locally, not only the providers we hold rates for. The last column is different: it counts only the peers we hold rates for, which is what the rate column rests on.
InsurerMedian rateMembers per local provider (est.)Local peers
BCBS North Carolina$158More members per local provider62
Aetna$142More members per local provider42
Cigna$137More members per local provider35
UnitedHealthcare$134More members per local provider56
Ambetter (Centene)$131Typical31

Not shown: MedCost (no estimate of how many people they cover in your area).

Each insurer, profiled.

One card per insurer in the Raleigh, NC area, measured against the area average of $142.

More info
The area average is the average of these insurers’ medians. ‘Local providers per member’ is the insurer’s estimated covered lives divided by every psychiatric NPs practising nearby, not only those we hold rates for.
Billing CodeOffice visit, established patient, moderate complexity

BCBS North Carolina

Median 99214
$158
75th-%ile rate
$182
Providers in peer group
62
Members per local provider (est.)
More members per local provider

The highest-paying insurer in your area. +11% vs. the area average

MedCost

Median 99214
$149
75th-%ile rate
$171
Providers in peer group
31

Pays around the average for your area.

+5% vs. the area average

Aetna

Median 99214
$142
75th-%ile rate
$163
Providers in peer group
42
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

at the area average

Cigna

Median 99214
$137
75th-%ile rate
$158
Providers in peer group
35
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

−3% vs. the area average

UnitedHealthcare

Median 99214
$134
75th-%ile rate
$154
Providers in peer group
56
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

−6% vs. the area average

Ambetter (Centene)

Median 99214
$131
75th-%ile rate
$151
Providers in peer group
31
Members per local provider (est.)
Typical

The lowest-paying insurer in your area.

−8% vs. the area average

What each insurer typically pays.

Every insurer with local rates for your credential, highest median first.

Billing CodeOffice visit, established patient, moderate complexity
InsurerMedian99214
  • Middle half of local rates (25th to 75th)
  • Median
BCBS North Carolina
$15825th–75th: $139–$182
MedCost
$14925th–75th: $131–$171
Aetna
$14225th–75th: $125–$163
Cigna
$13725th–75th: $121–$158
UnitedHealthcare
$13425th–75th: $118–$154
Ambetter (Centene)
$13125th–75th: $115–$151
Local 99214 rate range per insurer, highest median first.
Insurer25th percentileMedian75th percentileProviders
BCBS North Carolina$139$158$18262
MedCost$131$149$17131
Aetna$125$142$16342
Cigna$121$137$15835
UnitedHealthcare$118$134$15456
Ambetter (Centene)$115$131$15131
The band is the middle half of each insurer’s local rates; the marker is its median.
More info
An offer below the band is a fair reason to ask how the fee schedule was set.

Three caseload scenarios.

Estimated gross income for the same caseload at three different 99214 rates.

Billing CodeOffice visit, established patient, moderate complexityAssumptions

960 sessions per year.

Three caseload scenarios.

  1. Lower-rate example

    $125,760

    $131 per session

    Caseload entirely on the lowest-paying insurer in your area.

    Ambetter (Centene) only at $131 / 99214.

  2. Blended-rate example

    $144,000

    $150 per session

    Equal share across the top insurers by median rate.

    Equal-share average across BCBS North Carolina, MedCost, Aetna.

  3. Higher-rate example

    $174,720

    $182 per session

    Top insurer at the 75th-percentile rate, a level they pay roughly 1 in 4 of that insurer's providers.

    BCBS North Carolina at the 75th-percentile rate of $182.

All figures are gross, before taxes and overhead, and assume every scheduled session is billed and paid.

How well-supplied your area is for Psychiatric NPs.

How many psychiatric NPs practice near you per 100,000 residents, against the national rate.

In the Raleigh, NC area

Your read

Your area has about as many psychiatric NPs per resident as the country as a whole.

Comparison

National rate: about 19 practising psychiatric NPs per 100,000 people.

All rates at all the insurers on one curve.

Every local psychiatric NPs rate for Office visit, established patient, moderate complexity, from every insurer, on one smoothed curve.

Billing CodeOffice visit, established patient, moderate complexity
Peer rate distribution for CPT 99214The peer median is $147. 45 rates. Each small dot under the curve is one filed rate; the curve smooths them.densityMEDIAN $147P75 $172P25 $128$75$100$125$150$175$200$225
Peer rate distribution for CPT 99214
#Rate
Median$147
P75$172
1$93
2$98
3$103
4$107
5$109
6$113
7$116
8$120
9$122
10$122
11$127
12$128
13$129
14$132
15$133
16$135
17$136
18$139
19$140
20$142
21$143
22$144
23$147
24$149
25$150
26$152
27$155
28$159
29$160
30$161
31$163
32$165
33$169
34$172
35$175
36$176
37$180
38$182
39$186
40$188
41$192
42$197
43$203
44$208
45$218

The peer median is $147. 45 rates.

More info
Each small dot under the curve is one filed rate; the curve smooths them.

A general credentialing timeline.

Every insurer differs, but in general, credentialing looks something like this. Typically it can take 90–120 days.

  1. 1
    Week 0
    CAQH ready
    Profile complete and attestations current. An outdated CAQH profile is the most common avoidable delay.
  2. 2
    Week 1–2
    Apply
    Submit through the insurer's provider portal or via email. Confirmation usually arrives within a few business days, or you can email to confirm.
  3. 3
    Week 2–10
    Verification
    The insurer verifies license, board status, education, and work history. Make sure to respond if they request additional documentation.
  4. 4
    Week 10–14
    Review and offer
    The insurer will review the file. If approved, they will send you a contract to sign.
  5. 5
    Week 14–18
    Effective date
    Contract countersigned and an effective date set. Directory listings follow in about 30–60 days.
Some insurers move faster when they need more providers in your area.

Five clauses worth a careful read.

Common terms in a behavioral-health panel contract: what each one is, and what to watch for.

  1. Evergreen renewal terms

    Contracts auto-renew unless you give written notice, often 60 to 90 days before the anniversary.

    More info
    Put the exact window in your calendar so a planned non-renewal does not lapse into another term.

  2. MFN / parity clauses

    Asks you to extend your lowest rate with any insurer to this one.

    More info
    Any later improvement with another insurer can be matched downward here. Often negotiable; a strike-through with a short explanation is the usual approach.

  3. Code-substitution and down-coding policy

    Lets the insurer reassign a billed code to a lower-paying one after internal review.

    More info
    Distinct from medical-necessity denials. Often referenced under 'claims editing' or 'correct coding'; worth tracing to the policy document.

  4. Termination without cause

    Either side can end the agreement without cause on notice, often 90 days.

    More info
    Confirm the notice runs both ways and that continuity-of-care duties for clients mid-treatment are spelled out.

  5. Fee-schedule reference

    Some contracts reference a fee schedule instead of attaching it.

    More info
    Ask in writing for the current and any pending versions before signing.
A one-time attorney review is typical for a first contract; most state associations keep a referral list.

Learn more about how we generate these numbers on our methodology page.

Something off?

Flag this report.

If a number looks wrong (a stale file, a rate that doesn’t match your remittance), tell us and we’ll check it.

Source: each insurer’s Transparency in Coverage filings. For information only; not financial, legal, insurance, or negotiation advice.

This is a sample. Yours uses real published rates for you and your local peers.

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