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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, PA-C
Market
Raleigh, NC
ZIP code
27601
Report date
July 30, 2026
Peers
50 psychiatric PAs

The lay of the land, at a glance.

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

Billing CodeOffice visit, established patient, moderate complexity
psychiatric PAs in your area
50
In-network across major commercial payers in the Raleigh, NC area.
Median insurer rate (99214)
$137
Half the insurers near you pay more than this per session, half less.
Highest-paying insurer
BCBS North Carolina
Median 99214 rate $154, about 13% above the area median.
Rate spread
$25
BCBS North Carolina ($154) pays $25 more per session than Ambetter (Centene) ($129) .

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 PAs per session, in the Raleigh, NC area.

Every insurer’s 99214 rates for psychiatric PAs 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 PA's published rate; the shaded band is the middle half, the line its median. Bigger dots are several providers at one rate. 44 rates across 6 insurers.Across allcommercial payersN = 44MEDIAN $143Typical rates$100$125$150$175$200
Peer rate dot plot for CPT 99214
PayerRateMarker
Across all commercial payers$143median
Across all commercial payers$167p75
Across all commercial payers$93
Across all commercial payers$98
Across all commercial payers$102
Across all commercial payers$106
Across all commercial payers$108
Across all commercial payers$111
Across all commercial payers$114
Across all commercial payers$118
Across all commercial payers$120
Across all commercial payers$120
Across all commercial payers$124
Across all commercial payers$126
Across all commercial payers$127
Across all commercial payers$130
Across all commercial payers$130
Across all commercial payers$133
Across all commercial payers$133
Across all commercial payers$136
Across all commercial payers$137
Across all commercial payers$139
Across all commercial payers$140
Across all commercial payers$141
Across all commercial payers$144
Across all commercial payers$146
Across all commercial payers$147
Across all commercial payers$149
Across all commercial payers$152
Across all commercial payers$156
Across all commercial payers$157
Across all commercial payers$158
Across all commercial payers$160
Across all commercial payers$162
Across all commercial payers$166
Across all commercial payers$169
Across all commercial payers$171
Across all commercial payers$173
Across all commercial payers$177
Across all commercial payers$179
Across all commercial payers$183
Across all commercial payers$185
Across all commercial payers$189
Across all commercial payers$194
Across all commercial payers$200
Across all commercial payers$205

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

More info
Bigger dots are several providers at one rate. 44 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 PAs rate and by how many people it covers per local provider.

Panel opportunity map

Psychiatric PAs · 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 PAs on CPT 99214. The average of their medians is $138 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$154More members per local provider31
Aetna$139More members per local provider31
Cigna$134More members per local provider31
UnitedHealthcare$132More members per local provider31
Ambetter (Centene)$129More members per local provider31

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 $139.

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 PAs practising nearby, not only those we hold rates for.
Billing CodeOffice visit, established patient, moderate complexity

BCBS North Carolina

Median 99214
$154
75th-%ile rate
$177
Providers in peer group
31
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
$146
75th-%ile rate
$168
Providers in peer group
31

Pays around the average for your area.

+5% vs. the area average

Aetna

Median 99214
$139
75th-%ile rate
$160
Providers in peer group
31
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

at the area average

Cigna

Median 99214
$134
75th-%ile rate
$154
Providers in peer group
31
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

−4% vs. the area average

UnitedHealthcare

Median 99214
$132
75th-%ile rate
$152
Providers in peer group
31
Members per local provider (est.)
More members per local provider

Pays around the average for your area.

−5% vs. the area average

Ambetter (Centene)

Median 99214
$129
75th-%ile rate
$148
Providers in peer group
31
Members per local provider (est.)
More members per local provider

The lowest-paying insurer in your area.

−7% 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
$15425th–75th: $136–$177
MedCost
$14625th–75th: $128–$168
Aetna
$13925th–75th: $122–$160
Cigna
$13425th–75th: $118–$154
UnitedHealthcare
$13225th–75th: $116–$152
Ambetter (Centene)
$12925th–75th: $114–$148
Local 99214 rate range per insurer, highest median first.
Insurer25th percentileMedian75th percentileProviders
BCBS North Carolina$136$154$17731
MedCost$128$146$16831
Aetna$122$139$16031
Cigna$118$134$15431
UnitedHealthcare$116$132$15231
Ambetter (Centene)$114$129$14831
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

    $123,840

    $129 per session

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

    Ambetter (Centene) only at $129 / 99214.

  2. Blended-rate example

    $140,160

    $146 per session

    Equal share across the top insurers by median rate.

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

  3. Higher-rate example

    $169,920

    $177 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 $177.

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 PAs.

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

In the Raleigh, NC area

Your read

Your area has significantly fewer psychiatric PAs per resident than the country as a whole, under half the national rate.

Comparison

National rate: about 68 practising psychiatric PAs per 100,000 people.

All rates at all the insurers on one curve.

Every local psychiatric PAs 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 $143. 44 rates. Each small dot under the curve is one filed rate; the curve smooths them.densityMEDIAN $143P75 $167P25 $126$75$100$125$150$175$200
Peer rate distribution for CPT 99214
#Rate
Median$143
P75$167
1$93
2$98
3$102
4$106
5$108
6$111
7$114
8$118
9$120
10$120
11$124
12$126
13$127
14$130
15$130
16$133
17$133
18$136
19$137
20$139
21$140
22$141
23$144
24$146
25$147
26$149
27$152
28$156
29$157
30$158
31$160
32$162
33$166
34$169
35$171
36$173
37$177
38$179
39$183
40$185
41$189
42$194
43$200
44$205

The peer median is $143. 44 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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