CPT 96372 · professional fee

Ther/proph/diag inj sc/im (CPT 96372): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 96372, 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

$24

P10 to P90: $14 to $45

vs Medicare

156%

non-facility rate $15.36

Payer spread

1.38×

Cigna $26 vs Aetna $19

State spread

2.8×

WI $42 to AZ $15

5,490 sampled providers7,813 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 96372 in the files analyzed, at $26, 38% above Aetna ($19), the lowest of the 4 payers shown.

The state spread is 2.8×: Wisconsin has the highest median at $42 and Arizona the lowest at $15, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 156% of the Medicare non-facility rate ($15.36), which ranks 104th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Cigna (interquartile range $14) and widest within UnitedHealthcare ($17).

This is a top-36 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	$26	$19	$33	+7%	1	4,164	167% of Medicare
UnitedHealthcare	$26	$19	$36	+7%	2	4,251	166% of Medicare
Blue Cross Blue Shield	$24	$18	$34	+1%	3	4,247	158% of Medicare
Aetna	$19	$15	$26	-23%	4	3,196	121% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($15.36)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Wisconsin	$42	+75%	UHC	Aetna	106
2	Alaska	$38	+59%	BCBS	Cigna	97
3	Connecticut	$38	+58%	BCBS	UHC	119
4	Minnesota	$34	+43%	UHC	Aetna	112
5	New Hampshire	$34	+41%	UHC	Aetna	110
6	Oregon	$34	+40%	Cigna	Aetna	99
7	North Carolina	$32	+34%	BCBS	Aetna	124
8	District of Columbia	$32	+33%	UHC	BCBS	84
9	North Dakota	$32	+32%	BCBS	Aetna	108
10	Washington	$32	+32%	BCBS	Aetna	110
11	South Dakota	$30	+24%	BCBS	Aetna	123
12	Massachusetts	$30	+24%	UHC	Aetna	121
13	Nebraska	$30	+24%	UHC	BCBS	89
14	Iowa	$28	+18%	UHC	Aetna	99
15	Maine	$28	+15%	BCBS	Aetna	120
16	California	$27	+14%	BCBS	Aetna	97
17	Vermont	$27	+12%	UHC	Aetna	108
18	Wyoming	$26	+8%	Cigna	Aetna	105
19	Illinois	$26	+6%	BCBS	Aetna	89
20	Rhode Island	$25	+4%	Aetna	Cigna	98
21	Ohio	$25	+4%	BCBS	Aetna	120
22	Kansas	$25	+4%	BCBS	Aetna	110
23	Arkansas	$25	+3%	Cigna	BCBS	121
24	New Jersey	$24	+0%	Cigna	BCBS	113
25	New Mexico	$24	+0%	UHC	Aetna	106
26	Pennsylvania	$24	-0%	Cigna	Aetna	108
27	Colorado	$23	-3%	Cigna	Aetna	115
28	Idaho	$23	-4%	UHC	Aetna	108
29	Mississippi	$23	-5%	BCBS	Aetna	101
30	Montana	$23	-6%	UHC	BCBS	103
31	Utah	$22	-6%	BCBS	UHC	107
32	Missouri	$22	-7%	Cigna	Aetna	114
33	New York	$22	-8%	UHC	BCBS	115
34	Georgia	$22	-8%	Cigna	BCBS	120
35	Kentucky	$22	-9%	Cigna	Aetna	127
35	Tennessee	$22	-9%	UHC	Aetna	107
37	Oklahoma	$21	-11%	UHC	BCBS	109
38	South Carolina	$20	-15%	BCBS	Aetna	101
39	Florida	$20	-18%	UHC	Cigna	104
40	West Virginia	$20	-19%	UHC	Aetna	114
40	Indiana	$20	-19%	Cigna	Aetna	123
42	Texas	$19	-20%	UHC	Aetna	122
43	Alabama	$19	-20%	Cigna	UHC	103
44	Louisiana	$19	-21%	UHC	Aetna	113
44	Virginia	$19	-21%	Cigna	BCBS	98
46	Hawaii	$19	-22%	BCBS	Cigna	78
47	Nevada	$18	-24%	BCBS	Aetna	110
48	Maryland	$18	-24%	Cigna	BCBS	94
49	Delaware	$17	-27%	Cigna	BCBS	107
50	Michigan	$16	-32%	UHC	BCBS	105
51	Arizona	$15	-38%	Cigna	Aetna	96

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 96372?

In the files we analyzed, Cigna, at a median of $26 across 4,164 sampled providers. Aetna is lowest at $19, 38% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 156% of the 2026 Medicare non-facility rate of $15.36.

Which state has the highest median for CPT 96372?

Wisconsin has the highest median at $42; Arizona has the lowest at $15.

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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