CPT 99349 · professional fee

Home/res vst est mod mdm 40 (CPT 99349): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99349, 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

$174

P10 to P90: $107 to $300

vs Medicare

132%

non-facility rate $132.27

Payer spread

1.70×

UHC $192 vs Aetna $113

State spread

2.9×

AK $311 to AL $107

5,435 sampled providers7,647 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 99349 in the files analyzed, at $192, 70% above Aetna ($113), the lowest of the 4 payers shown.

The state spread is 2.9×: Alaska has the highest median at $311 and Alabama the lowest at $107, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 132% of the Medicare non-facility rate ($132.27), which ranks 150th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $40) and widest within UnitedHealthcare ($111).

This is a top-17 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
UnitedHealthcare	$192	$144	$255	+10%	1	4,246	145% of Medicare
Blue Cross Blue Shield	$181	$131	$219	+4%	2	4,163	137% of Medicare
Cigna	$181	$137	$234	+4%	3	4,175	137% of Medicare
Aetna	$113	$101	$140	-35%	4	2,253	85% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($132.27)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$311	+78%	UHC	Cigna	90
2	Oregon	$292	+68%	UHC	Aetna	98
3	Wisconsin	$291	+67%	UHC	Aetna	106
4	Washington	$262	+50%	UHC	Aetna	109
5	Minnesota	$257	+47%	UHC	Aetna	112
6	North Dakota	$256	+47%	BCBS	Aetna	105
7	Nebraska	$246	+41%	UHC	Aetna	89
8	Massachusetts	$239	+37%	UHC	Aetna	118
9	District of Columbia	$215	+23%	UHC	BCBS	83
10	North Carolina	$204	+17%	UHC	Aetna	124
11	Connecticut	$203	+17%	UHC	Aetna	118
12	South Dakota	$203	+16%	Cigna	Aetna	123
13	Montana	$199	+14%	UHC	Cigna	102
14	Wyoming	$197	+13%	BCBS	Aetna	105
15	Georgia	$196	+13%	UHC	Aetna	120
16	Idaho	$195	+12%	Cigna	Aetna	108
17	Colorado	$193	+11%	BCBS	Aetna	114
18	New Hampshire	$187	+7%	UHC	Aetna	110
19	Iowa	$184	+6%	UHC	Aetna	99
20	New Mexico	$178	+2%	UHC	BCBS	103
21	Illinois	$177	+2%	UHC	Aetna	88
22	Utah	$177	+2%	BCBS	UHC	107
23	Vermont	$176	+1%	UHC	BCBS	106
23	Maine	$176	+1%	UHC	Aetna	120
25	Pennsylvania	$175	+0%	UHC	Aetna	108
26	South Carolina	$175	+0%	UHC	Aetna	100
27	Ohio	$167	-4%	UHC	Aetna	120
28	Kansas	$166	-5%	BCBS	Aetna	110
29	California	$164	-6%	Cigna	Aetna	96
30	New Jersey	$164	-6%	BCBS	Aetna	112
31	Arkansas	$163	-6%	UHC	Aetna	120
32	Michigan	$162	-7%	BCBS	Aetna	102
33	Tennessee	$159	-8%	UHC	Aetna	105
34	Hawaii	$158	-10%	Cigna	BCBS	77
35	Oklahoma	$155	-11%	Cigna	Aetna	109
36	Missouri	$153	-12%	UHC	Aetna	114
37	New York	$150	-14%	UHC	Aetna	114
38	West Virginia	$148	-15%	UHC	Aetna	114
39	Virginia	$146	-16%	UHC	Aetna	97
40	Rhode Island	$144	-17%	UHC	Aetna	97
41	Kentucky	$143	-18%	Cigna	Aetna	125
42	Louisiana	$141	-19%	UHC	Aetna	109
43	Indiana	$137	-21%	UHC	Aetna	123
44	Maryland	$131	-25%	Cigna	Aetna	94
45	Texas	$129	-26%	Cigna	Aetna	120
46	Delaware	$129	-26%	UHC	Aetna	107
47	Florida	$127	-27%	UHC	Aetna	102
48	Nevada	$126	-28%	UHC	Aetna	106
49	Mississippi	$125	-28%	UHC	Aetna	99
50	Arizona	$114	-35%	UHC	Aetna	95
51	Alabama	$107	-39%	BCBS	Aetna	103

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 99349?

In the files we analyzed, UnitedHealthcare, at a median of $192 across 4,246 sampled providers. Aetna is lowest at $113, 70% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 132% of the 2026 Medicare non-facility rate of $132.27.

Which state has the highest median for CPT 99349?

Alaska has the highest median at $311; Alabama has the lowest at $107.

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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