CPT 99454 · professional fee

Rem mntr physiol param 16-30 (CPT 99454): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99454, from their published in-network rate files.

Cardiology Internal medicineSnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$75

P10 to P90: $45 to $129

vs Medicare

145%

non-facility rate $52.11

Payer spread

1.77×

UHC $89 vs Aetna $50

State spread

2.7×

WI $130 to MS $49

10,464 sampled providers12,191 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 99454 in the files analyzed, at $89, 77% above Aetna ($50), the lowest of the 4 payers shown.

The state spread is 2.7×: Wisconsin has the highest median at $130 and Mississippi the lowest at $49, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 145% of the Medicare non-facility rate ($52.11), which ranks 128th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $23) and widest within UnitedHealthcare ($49).

This is a top-24 code for cardiology 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	$89	$67	$116	+18%	1	8,541	170% of Medicare
Cigna	$77	$60	$100	+3%	2	8,170	148% of Medicare
Blue Cross Blue Shield	$74	$58	$94	-2%	3	7,931	142% of Medicare
Aetna	$50	$42	$65	-33%	4	4,098	96% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($52.11)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Wisconsin	$130	+73%	UHC	Aetna	213
2	Oregon	$118	+57%	UHC	BCBS	190
3	Alaska	$116	+55%	UHC	Cigna	124
4	Washington	$110	+46%	UHC	Aetna	218
5	Massachusetts	$100	+32%	UHC	Aetna	223
6	Minnesota	$99	+31%	UHC	Aetna	214
7	North Dakota	$97	+29%	UHC	Aetna	135
8	North Carolina	$97	+29%	UHC	Aetna	250
9	New Hampshire	$93	+23%	UHC	Aetna	224
10	Georgia	$92	+22%	UHC	Aetna	248
11	District of Columbia	$90	+20%	Aetna	BCBS	162
12	Nebraska	$90	+19%	UHC	Aetna	170
13	Connecticut	$88	+17%	BCBS	Aetna	237
14	Vermont	$88	+17%	UHC	BCBS	131
15	California	$87	+15%	Cigna	Aetna	204
16	New Jersey	$85	+13%	BCBS	Aetna	225
17	Idaho	$85	+13%	Cigna	Aetna	167
18	Wyoming	$85	+13%	UHC	Aetna	124
19	Colorado	$84	+12%	UHC	Aetna	241
20	Maine	$81	+7%	UHC	Aetna	215
21	South Dakota	$80	+6%	Cigna	Aetna	157
22	New Mexico	$78	+4%	UHC	BCBS	183
23	New York	$78	+3%	UHC	Aetna	236
24	Kansas	$77	+2%	UHC	Aetna	230
25	Ohio	$77	+2%	UHC	Aetna	236
26	Pennsylvania	$75	-0%	UHC	Aetna	206
27	Michigan	$75	-1%	Cigna	Aetna	224
28	Montana	$75	-1%	UHC	Aetna	149
29	Utah	$74	-2%	BCBS	Aetna	204
30	Iowa	$71	-5%	UHC	Aetna	211
31	Delaware	$70	-7%	UHC	Aetna	179
32	Missouri	$70	-7%	UHC	Aetna	234
33	Tennessee	$70	-7%	UHC	Aetna	227
34	Oklahoma	$69	-8%	UHC	Aetna	227
35	Illinois	$69	-8%	UHC	Aetna	206
36	West Virginia	$69	-9%	UHC	Aetna	194
37	Rhode Island	$67	-11%	UHC	BCBS	188
38	Virginia	$66	-12%	UHC	BCBS	219
38	South Carolina	$66	-12%	BCBS	Aetna	216
40	Nevada	$65	-14%	BCBS	Aetna	222
41	Kentucky	$65	-14%	Cigna	Aetna	253
42	Indiana	$65	-14%	UHC	Aetna	245
43	Arkansas	$63	-17%	Cigna	BCBS	239
44	Hawaii	$62	-18%	BCBS	Cigna	131
45	Florida	$60	-20%	UHC	Aetna	213
46	Maryland	$58	-22%	UHC	Aetna	205
47	Louisiana	$58	-23%	UHC	BCBS	215
48	Texas	$57	-24%	UHC	BCBS	249
49	Arizona	$56	-25%	UHC	Aetna	192
50	Alabama	$49	-35%	UHC	Aetna	228
51	Mississippi	$49	-35%	UHC	Aetna	231

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 99454?

In the files we analyzed, UnitedHealthcare, at a median of $89 across 8,541 sampled providers. Aetna is lowest at $50, 77% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 145% of the 2026 Medicare non-facility rate of $52.11.

Which state has the highest median for CPT 99454?

Wisconsin has the highest median at $130; Mississippi has the lowest at $49.

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.

See how your contracts compare for CPT 99454

Benchmark your negotiated rates for 99454 and the rest of your book against these payer and state medians.

Request a rate benchmark