Methodology

Every price on this site is an in-network negotiated rate taken from UnitedHealthcare’s Transparency in Coverage machine-readable files. Under federal rules in effect since July 2022, insurers must publish, for every in-network provider and every billing code, the rate they have agreed to pay. These are not list prices, estimates, or averages; they are contract prices.

The files identify providers by National Provider Identifier (NPI). We join each rate to the CMS National Plan and Provider Enumeration System (NPPES) to get the doctor’s name, credential, practice address, phone number, and taxonomy (specialty).

We currently list 488 doctors in 162 California cities. A doctor appears on this site only if all of the following are true:

• Their primary NPPES taxonomy is Family Medicine or Internal Medicine, and their practice address is in California.
• The insurer file contains rates attached to the doctor’s own individual NPI (type 1). Rates reported only for a medical group, facility, or specialty average are excluded, because they do not describe what that specific doctor is paid.
• At least one of those rates is for a standard office visit (CPT 99202–99215) or preventive visit (CPT 99381–99397).
• The NPI is active.

We also remove visit rates that cannot be fee-for-service prices. When a doctor’s file shows the same amount of $100 or less for two or more different visit levels (for example, a 15-minute follow-up and a 60-minute new patient visit both at $80), those entries reflect a capitated or placeholder arrangement rather than a price for the visit, and we drop them. If nothing remains, the doctor is not listed.

Who gets a full page. 409 doctors have their own page. To qualify, the insurer must price at least three different office or preventive visit types for the doctor. With one or two priced visits there is not enough to say anything specific, so rather than pad a profile with generic text we list those 79 doctors as rate rows on their city page.

These rules exclude the large majority of California primary care doctors. We think a short list of accurate, doctor-specific prices is more useful than a long list of specialty averages presented as if they were individual.

An insurer’s file usually contains several rows for the same doctor and code, one per plan or network product, and they do not always agree. The rate we show is the median across those rows. When the rows differ by 5% or more we also show the lowest and highest, so you can see the spread rather than a single number that may not be your plan’s.

Rates are grouped by the billing entity (the tax ID the contract is written under). When several doctors are paid under the same tax ID they have the same rate schedule, because the medical group or health system negotiated it, not the individual doctor. We say so on those pages and list the doctors who share the contract, rather than presenting an identical price as if each doctor had set it. Some doctors appear under two or more tax IDs; for them the median spans all of them and the page says so.

Hospital, emergency and consultation codes appear in many primary-care contracts because the contract covers every service the group might bill, not because the doctor performs them. We show these collapsed at the bottom of the rate table and never use them in benchmarks or comparisons.

The negotiated rate is the total amount the insurer and the patient together pay the doctor for that service. How it splits depends on your plan:

• Copay plans: you pay the copay (often $20–$50 for primary care); the insurer pays the rest of the negotiated rate.
• High-deductible plans, deductible not met: you pay the full negotiated rate.
• Coinsurance after deductible: you pay your percentage of the negotiated rate.
• Preventive visits: covered in full in-network on almost all plans, unless a separate problem-focused visit is billed the same day.

Rates are for UnitedHealthcare commercial plans. Other insurers negotiate separately. Rates for Medicare and Medi-Cal are set differently and are not shown.

Each doctor’s rate is shown alongside comparisons computed only from the doctors listed on this site (pages and rate rows alike):

• Benchmark median. The median rate for the same code among listed doctors in the same city, when at least three report it. Otherwise, the median among all listed doctors statewide.
• Position. Where the doctor ranks among listed doctors in the same city for that code, lowest first, or how they sit against listed doctors statewide when the city is small.
• Group rates. When three or more doctors in a city are paid the identical rate for a code, they are on the same contract, and the page says so once instead of ranking them against each other. When that group is large enough to set the city median itself, the comparison falls back to the statewide median.
• What you would pay. The three columns apply the negotiated rate to the three common plan situations: deductible not met (you owe the full rate), deductible met with coinsurance (shown at 20%), and a copay plan (you owe the copay). They are illustrations, not quotes.

We do not use the insurer file’s own city or state averages as benchmarks. Those averages include the flat placeholder rates described above, which pull them far below what any doctor listed here is actually paid for a fee-for-service visit.

Where shown, star ratings and review counts come from publicly visible listings on third-party sites such as Healthgrades, RateMDs, WebMD, Sharecare and U.S. News, and each site is named and linked so you can check it yourself. The headline rating is the review-count-weighted average across those sites. Several sites republish one another's figures; when two sites show the identical rating and count we count that set of reviews once. We only show a rating once a doctor has at least 5 public reviews; a perfect score from two reviews tells you nothing, and we say so on the page instead.

The “patients praise” and “patients criticize” themes are extracted from those public reviews by a language model, limited to points the reviews actually support, and shown only for doctors with reviews on at least two sites or ten or more reviews on one. Names of anyone other than the doctor are removed. Where reviews mention billing, insurance or unexpected charges, we note that next to the rates, since it bears directly on what you will pay. We do not collect, host, or moderate reviews, and ratings play no role in whether a doctor is listed.

• Insurer files are published monthly and lag contract changes. A rate may be out of date by the time you visit.
• A doctor appearing in the file indicates they were in-network for at least one UnitedHealthcare product when it was published; it does not guarantee they are in-network for your plan today or accepting new patients.
• Some doctors carry codes outside their office practice (hospital, emergency, or neonatal care). We show those separately and do not use them in benchmarks.
• NPPES addresses are self-reported by providers and can be stale.
• We list one insurer. A doctor’s rates with other insurers are usually in a similar range, but not identical.

If you are a listed doctor, work for the practice, or are a patient who spots an error, please tell us. We review every report and correct or remove listings when the underlying data is wrong. See our editorial policy.