Skip to main content

Sample report: real layout, made-up numbers.

Sample report: real insurer names, invented dollar figures.

This sample is for providers choosing which insurers to apply to. Already in-network? View the in-network rate sample →

Your local rates report

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

Prepared for
Carl Rogers, MD
Market
Raleigh, NC
ZIP code
27601
Report date
July 30, 2026
Peers
77 psychiatrists

The lay of the land, at a glance.

Four numbers that describe the market for psychiatrists (MD/DO) in the Raleigh, NC area.

Billing CodeOffice visit, established patient, moderate complexity
psychiatrists (MD/DO) in your area
77
In-network across major commercial payers in the Raleigh, NC area.
Median insurer rate (99214)
$165
Half the insurers near you pay more than this per session, half less.
Highest-paying insurer
BCBS North Carolina
Median 99214 rate $186, about 13% above the area median.
Rate spread
$31
BCBS North Carolina ($186) pays $31 more per session than Ambetter (Centene) ($155) .

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 psychiatrists (MD/DO) per session, in the Raleigh, NC area.

Every insurer’s 99214 rates for psychiatrists (MD/DO) 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 psychiatrist'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 $172Typical rates$100$125$150$175$200$225$250
Peer rate dot plot for CPT 99214
PayerRateMarker
Across all commercial payers$172median
Across all commercial payers$200p75
Across all commercial payers$109
Across all commercial payers$115
Across all commercial payers$121
Across all commercial payers$126
Across all commercial payers$128
Across all commercial payers$132
Across all commercial payers$136
Across all commercial payers$141
Across all commercial payers$143
Across all commercial payers$144
Across all commercial payers$149
Across all commercial payers$151
Across all commercial payers$152
Across all commercial payers$156
Across all commercial payers$156
Across all commercial payers$159
Across all commercial payers$160
Across all commercial payers$164
Across all commercial payers$165
Across all commercial payers$168
Across all commercial payers$169
Across all commercial payers$170
Across all commercial payers$173
Across all commercial payers$176
Across all commercial payers$176
Across all commercial payers$179
Across all commercial payers$183
Across all commercial payers$187
Across all commercial payers$189
Across all commercial payers$190
Across all commercial payers$193
Across all commercial payers$195
Across all commercial payers$199
Across all commercial payers$203
Across all commercial payers$206
Across all commercial payers$208
Across all commercial payers$212
Across all commercial payers$215
Across all commercial payers$220
Across all commercial payers$222
Across all commercial payers$226
Across all commercial payers$233
Across all commercial payers$240
Across all commercial payers$246

Each dot is one psychiatrist'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 psychiatrists (MD/DO) rate and by how many people it covers per local provider.

Panel opportunity map

Psychiatrists (MD/DO) · 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 psychiatrists (MD/DO) on CPT 99214. The average of their medians is $166 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$186More members per local provider42
Aetna$167More members per local provider31
Cigna$162More members per local provider31
UnitedHealthcare$158More members per local provider36
Ambetter (Centene)$155Typical31

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 $167.

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 psychiatrists (MD/DO) practising nearby, not only those we hold rates for.
Billing CodeOffice visit, established patient, moderate complexity

BCBS North Carolina

Median 99214
$186
75th-%ile rate
$214
Providers in peer group
42
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
$175
75th-%ile rate
$201
Providers in peer group
31

Pays around the average for your area.

+5% vs. the area average

Aetna

Median 99214
$167
75th-%ile rate
$192
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
$162
75th-%ile rate
$186
Providers in peer group
31
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
$158
75th-%ile rate
$182
Providers in peer group
36
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
$155
75th-%ile rate
$178
Providers in peer group
31
Members per local provider (est.)
Typical

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
$18625th–75th: $164–$214
MedCost
$17525th–75th: $154–$201
Aetna
$16725th–75th: $147–$192
Cigna
$16225th–75th: $143–$186
UnitedHealthcare
$15825th–75th: $139–$182
Ambetter (Centene)
$15525th–75th: $136–$178
Local 99214 rate range per insurer, highest median first.
Insurer25th percentileMedian75th percentileProviders
BCBS North Carolina$164$186$21442
MedCost$154$175$20131
Aetna$147$167$19231
Cigna$143$162$18631
UnitedHealthcare$139$158$18236
Ambetter (Centene)$136$155$17831
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

    $148,800

    $155 per session

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

    Ambetter (Centene) only at $155 / 99214.

  2. Blended-rate example

    $168,960

    $176 per session

    Equal share across the top insurers by median rate.

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

  3. Higher-rate example

    $205,440

    $214 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 $214.

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

How well-supplied your area is for Psychiatrists.

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

In the Raleigh, NC area

Your read

Your area has somewhat fewer psychiatrists per resident than the country as a whole.

Comparison

National rate: about 21 practising psychiatrists per 100,000 people.

All rates at all the insurers on one curve.

Every local psychiatrists (MD/DO) 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 $172. 44 rates. Each small dot under the curve is one filed rate; the curve smooths them.densityMEDIAN $172P75 $200P25 $151$100$125$150$175$200$225$250
Peer rate distribution for CPT 99214
#Rate
Median$172
P75$200
1$109
2$115
3$121
4$126
5$128
6$132
7$136
8$141
9$143
10$144
11$149
12$151
13$152
14$156
15$156
16$159
17$160
18$164
19$165
20$168
21$169
22$170
23$173
24$176
25$176
26$179
27$183
28$187
29$189
30$190
31$193
32$195
33$199
34$203
35$206
36$208
37$212
38$215
39$220
40$222
41$226
42$233
43$240
44$246

The peer median is $172. 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.

Get the full report · $99