CPT 99212 · professional fee

Office o/p est sf 10 min (CPT 99212): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99212, from their published in-network rate files.

Dermatology Orthopedic surgerySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$49

P10 to P90: $31 to $93

vs Medicare

83%

non-facility rate $59.45

Payer spread

1.56×

UHC $64 vs Aetna $41

State spread

2.3×

AK $88 to AZ $38

39,083 sampled providers36,150 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 99212 in the files analyzed, at $64, 56% above Aetna ($41), the lowest of the 4 payers shown.

The state spread is 2.3×: Alaska has the highest median at $88 and Arizona the lowest at $38, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 83% of the Medicare non-facility rate ($59.45), which ranks 227th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $16) and widest within UnitedHealthcare ($40).

This is a top-14 code for dermatology 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
UnitedHealthcare	$64	$47	$87	+30%	1	31,635	107% of Medicare
Blue Cross Blue Shield	$50	$40	$65	+1%	2	30,417	84% of Medicare
Cigna	$49	$36	$65	-0%	3	31,292	82% of Medicare
Aetna	$41	$34	$49	-17%	4	26,440	69% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($59.45)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$88	+80%	UHC	Cigna	328
2	Oregon	$81	+66%	UHC	Aetna	808
3	Wisconsin	$78	+59%	UHC	Aetna	867
4	Washington	$75	+53%	UHC	Aetna	868
5	Hawaii	$74	+50%	UHC	Aetna	502
6	Nebraska	$68	+39%	UHC	Aetna	601
7	Massachusetts	$68	+38%	UHC	Aetna	920
8	Wyoming	$63	+28%	UHC	Aetna	270
9	North Dakota	$63	+27%	BCBS	Aetna	343
10	Minnesota	$62	+27%	BCBS	Aetna	851
11	New Hampshire	$61	+23%	UHC	Aetna	732
12	District of Columbia	$58	+19%	UHC	BCBS	520
13	Idaho	$58	+18%	UHC	Aetna	616
14	Vermont	$57	+16%	UHC	Aetna	340
15	Georgia	$57	+15%	UHC	Aetna	977
16	Maine	$56	+14%	UHC	Aetna	647
17	Montana	$55	+12%	UHC	Aetna	446
18	Colorado	$54	+10%	UHC	Aetna	944
19	South Dakota	$53	+9%	UHC	Aetna	473
20	North Carolina	$53	+7%	UHC	Aetna	1,009
21	Pennsylvania	$51	+4%	UHC	Cigna	886
22	Iowa	$51	+4%	UHC	Aetna	712
23	Connecticut	$50	+2%	UHC	Aetna	933
24	New Jersey	$49	+0%	UHC	Aetna	884
25	California	$49	-0%	UHC	Aetna	844
26	Illinois	$48	-2%	UHC	BCBS	881
27	Ohio	$48	-2%	UHC	Aetna	934
28	Oklahoma	$48	-3%	UHC	Cigna	836
29	Delaware	$47	-4%	Cigna	BCBS	459
30	New York	$47	-4%	UHC	Aetna	942
31	New Mexico	$47	-4%	UHC	BCBS	621
32	Virginia	$46	-7%	UHC	Aetna	901
33	Tennessee	$46	-7%	UHC	Aetna	942
34	Rhode Island	$46	-7%	UHC	BCBS	632
35	Kansas	$45	-8%	Cigna	Aetna	790
36	Missouri	$45	-8%	UHC	Aetna	952
37	Utah	$45	-9%	UHC	Aetna	817
38	Indiana	$45	-9%	BCBS	Aetna	962
39	West Virginia	$44	-10%	UHC	BCBS	607
40	Maryland	$44	-10%	UHC	BCBS	848
41	Michigan	$44	-11%	Cigna	Aetna	866
42	South Carolina	$43	-12%	UHC	Aetna	865
43	Nevada	$43	-12%	UHC	Aetna	776
44	Kentucky	$43	-12%	UHC	Aetna	976
45	Texas	$42	-14%	UHC	BCBS	1,020
46	Louisiana	$42	-15%	UHC	Aetna	915
47	Mississippi	$42	-15%	BCBS	Aetna	778
48	Florida	$41	-17%	UHC	Aetna	889
49	Arkansas	$41	-17%	UHC	Cigna	786
50	Alabama	$39	-21%	UHC	Aetna	950
51	Arizona	$38	-23%	UHC	BCBS	817

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 99212?

In the files we analyzed, UnitedHealthcare, at a median of $64 across 31,635 sampled providers. Aetna is lowest at $41, 56% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 83% of the 2026 Medicare non-facility rate of $59.45.

Which state has the highest median for CPT 99212?

Alaska has the highest median at $88; Arizona has the lowest at $38.

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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