CPT 90960 · professional fee

Esrd srv 4 visits p mo 20+ (CPT 90960): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 90960, from their published in-network rate files.

Internal medicineSnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$453

P10 to P90: $295 to $894

vs Medicare

121%

non-facility rate $372.75

Payer spread

1.30×

Cigna $485 vs Aetna $374

State spread

2.5×

WI $869 to FL $347

5,416 sampled providers7,541 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Cigna has the highest median for CPT 90960 in the files analyzed, at $485, 30% above Aetna ($374), the lowest of the 4 payers shown.

The state spread is 2.5×: Wisconsin has the highest median at $869 and Florida the lowest at $347, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 121% of the Medicare non-facility rate ($372.75), which ranks 165th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $124) and widest within UnitedHealthcare ($332).

This is a top-21 code for internal medicine by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
Cigna	$485	$367	$654	+7%	1	4,166	130% of Medicare
UnitedHealthcare	$481	$353	$685	+6%	2	4,245	129% of Medicare
Blue Cross Blue Shield	$476	$381	$658	+5%	3	4,090	128% of Medicare
Aetna	$374	$328	$453	-17%	4	1,992	100% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($372.75)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Wisconsin	$869	+92%	BCBS	Cigna	106
2	Alaska	$800	+77%	BCBS	Cigna	89
3	Washington	$742	+64%	UHC	BCBS	109
4	Oregon	$722	+59%	UHC	Aetna	97
5	Minnesota	$707	+56%	BCBS	Aetna	112
6	Massachusetts	$699	+55%	UHC	Aetna	118
7	Nebraska	$670	+48%	Cigna	BCBS	89
8	Iowa	$661	+46%	Cigna	Aetna	99
9	North Dakota	$655	+45%	BCBS	Aetna	105
10	Connecticut	$646	+43%	UHC	Aetna	118
11	South Dakota	$597	+32%	BCBS	Aetna	123
12	New Hampshire	$531	+17%	UHC	Aetna	109
13	Colorado	$531	+17%	BCBS	Aetna	114
14	Georgia	$521	+15%	BCBS	Aetna	120
15	North Carolina	$517	+14%	Cigna	Aetna	124
16	Montana	$511	+13%	BCBS	UHC	92
17	Wyoming	$510	+13%	BCBS	Aetna	105
18	Utah	$499	+10%	UHC	BCBS	107
19	Idaho	$492	+9%	Cigna	UHC	106
20	Illinois	$477	+5%	Cigna	Aetna	86
21	Ohio	$470	+4%	UHC	Aetna	120
22	New Mexico	$462	+2%	UHC	BCBS	102
23	District of Columbia	$460	+2%	Aetna	BCBS	82
24	Arkansas	$452	-0%	UHC	Aetna	120
25	Maine	$447	-1%	Cigna	Aetna	120
26	Hawaii	$442	-2%	Cigna	BCBS	76
27	South Carolina	$436	-4%	Cigna	Aetna	100
28	Oklahoma	$434	-4%	BCBS	Aetna	109
29	Michigan	$433	-4%	BCBS	UHC	102
30	Pennsylvania	$432	-5%	UHC	Aetna	108
31	Kansas	$426	-6%	Aetna	BCBS	110
32	Missouri	$420	-7%	Aetna	BCBS	114
33	Tennessee	$415	-8%	BCBS	Aetna	104
34	Texas	$411	-9%	Cigna	Aetna	117
35	New Jersey	$405	-10%	BCBS	Aetna	112
36	California	$405	-10%	Cigna	Aetna	96
37	Rhode Island	$403	-11%	UHC	Aetna	98
38	Vermont	$402	-11%	UHC	BCBS	108
39	Alabama	$400	-12%	Aetna	Cigna	103
39	Maryland	$400	-12%	Cigna	Aetna	94
41	Mississippi	$399	-12%	Aetna	UHC	99
42	Louisiana	$398	-12%	UHC	Aetna	111
43	Virginia	$398	-12%	Cigna	Aetna	97
44	West Virginia	$393	-13%	UHC	BCBS	113
45	Kentucky	$386	-15%	UHC	BCBS	125
46	New York	$374	-17%	UHC	Aetna	115
47	Indiana	$366	-19%	Cigna	UHC	123
48	Delaware	$360	-20%	Aetna	BCBS	107
49	Nevada	$355	-22%	Aetna	Cigna	106
50	Arizona	$347	-23%	BCBS	UHC	95
51	Florida	$347	-23%	BCBS	Aetna	102

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 90960?

In the files we analyzed, Cigna, at a median of $485 across 4,166 sampled providers. Aetna is lowest at $374, 30% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 121% of the 2026 Medicare non-facility rate of $372.75.

Which state has the highest median for CPT 90960?

Wisconsin has the highest median at $869; Florida has the lowest at $347.

Is this a professional fee?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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