CPT 99350 · professional fee

Home/res vst est high mdm 60 (CPT 99350): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99350, 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
$247
P10 to P90: $152 to $428
vs Medicare
128%
non-facility rate $193.06
Payer spread
1.73×
UHC $271 vs Aetna $157
State spread
3.0×
AK $453 to AL $151
5,431 sampled providers7,634 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers
1

UnitedHealthcare has the highest median for CPT 99350 in the files analyzed, at $271, 73% above Aetna ($157), the lowest of the 4 payers shown.

2

The state spread is 3.0×: Alaska has the highest median at $453 and Alabama the lowest at $151, a gap larger than the gap between the highest and lowest payer.

3

Commercial rates run 128% of the Medicare non-facility rate ($193.06), which ranks 155th of 228 tracked codes by commercial-to-Medicare ratio.

4

Rates are tightest within Aetna (interquartile range $45) and widest within UnitedHealthcare ($159).

5

This is a top-25 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
PayerMedianP25P75vs nationalRankProvidersPosition
UnitedHealthcare$271$204$363+10%14,246
140% of Medicare
Cigna$259$192$329+5%24,175
134% of Medicare
Blue Cross Blue Shield$256$187$319+4%34,163
133% of Medicare
Aetna$157$145$190-37%42,056
81% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($193.06)
$117$199$280$362$443$524UnitedHealthcareCignaBlue Cross Blue ShieldAetnaMedicare

Rates by state

Median across payers · 51 states with enough data
RankStateMedianvs nationalHighest payerLowest payerProvidersLevel
1Alaska$453+83%UHCCigna89
2Wisconsin$424+72%UHCAetna106
3Oregon$412+67%UHCAetna98
4Minnesota$374+51%UHCAetna112
5North Dakota$372+51%BCBSAetna105
6Washington$364+47%UHCAetna109
7Nebraska$346+40%UHCBCBS89
8Massachusetts$341+38%UHCAetna118
9District of Columbia$299+21%UHCBCBS83
10Montana$290+17%UHCCigna102
11North Carolina$290+17%UHCAetna124
12South Dakota$290+17%CignaAetna123
13Connecticut$287+16%UHCAetna118
14Wyoming$282+14%BCBSAetna105
15New Hampshire$276+12%UHCAetna110
16Colorado$275+11%BCBSAetna114
17Idaho$275+11%CignaAetna106
18Georgia$274+11%UHCAetna120
19Iowa$267+8%UHCAetna99
20Illinois$259+5%UHCAetna88
21Utah$258+4%BCBSUHC107
22South Carolina$255+3%UHCAetna100
23Kansas$254+3%CignaAetna109
24Vermont$252+2%UHCBCBS106
25New Mexico$251+2%UHCAetna103
26Maine$249+1%UHCAetna120
27Pennsylvania$245-1%UHCAetna108
28California$244-1%CignaAetna96
29Ohio$242-2%UHCAetna120
30Michigan$241-2%BCBSAetna101
31Arkansas$231-6%UHCAetna120
32Hawaii$228-8%CignaBCBS77
33New Jersey$228-8%BCBSAetna113
34Tennessee$227-8%UHCAetna105
35Oklahoma$222-10%UHCAetna109
36West Virginia$220-11%UHCAetna114
37Missouri$213-14%CignaAetna114
38Rhode Island$209-15%UHCAetna97
39Virginia$208-16%UHCAetna96
40New York$206-17%UHCAetna114
41Kentucky$205-17%CignaAetna125
42Indiana$197-20%UHCAetna123
43Louisiana$196-21%UHCAetna109
44Delaware$187-24%UHCAetna107
45Texas$187-24%CignaAetna120
46Mississippi$182-26%BCBSAetna100
47Florida$181-27%UHCAetna102
48Nevada$177-28%UHCAetna106
49Maryland$169-32%CignaAetna94
50Arizona$166-33%UHCAetna95
51Alabama$151-39%BCBSAetna103

Frequently asked questions

Answers use this page's data
Which payer has the highest median rate for CPT 99350?

In the files we analyzed, UnitedHealthcare, at a median of $271 across 4,246 sampled providers. Aetna is lowest at $157, 73% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 128% of the 2026 Medicare non-facility rate of $193.06.

Which state has the highest median for CPT 99350?

Alaska has the highest median at $453; Alabama has the lowest at $151.

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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