CPT 99457 · professional fee

Rpm tx mgmt 1st 20 min (CPT 99457): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99457, 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

$53

P10 to P90: $29 to $100

vs Medicare

102%

non-facility rate $51.77

Payer spread

2.37×

UHC $73 vs Aetna $31

State spread

3.0×

AK $102 to AL $34

10,466 sampled providers12,197 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 99457 in the files analyzed, at $73, 137% above Aetna ($31), the lowest of the 4 payers shown.

The state spread is 3.0×: Alaska has the highest median at $102 and Alabama the lowest at $34, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 102% of the Medicare non-facility rate ($51.77), which ranks 192nd of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $12) and widest within Blue Cross Blue Shield ($28).

This is a top-22 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	$73	$57	$99	+39%	1	8,550	142% of Medicare
Cigna	$50	$40	$64	-5%	2	8,154	97% of Medicare
Blue Cross Blue Shield	$48	$37	$65	-9%	3	7,953	93% of Medicare
Aetna	$31	$27	$39	-41%	4	4,193	60% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($51.77)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$102	+93%	UHC	Aetna	124
2	Wisconsin	$83	+57%	UHC	Aetna	213
3	Oregon	$81	+54%	UHC	Aetna	190
4	Minnesota	$78	+47%	UHC	Aetna	214
5	North Dakota	$75	+41%	UHC	Aetna	135
6	Washington	$73	+38%	UHC	Aetna	218
7	Nebraska	$70	+32%	UHC	Aetna	170
8	New Hampshire	$69	+30%	UHC	Aetna	226
9	North Carolina	$68	+29%	UHC	Aetna	250
10	Vermont	$65	+24%	UHC	BCBS	131
11	Massachusetts	$65	+22%	UHC	Aetna	225
12	Hawaii	$64	+21%	Cigna	BCBS	131
13	Connecticut	$64	+21%	UHC	Aetna	237
14	South Dakota	$61	+15%	UHC	Aetna	157
15	Georgia	$61	+15%	UHC	Aetna	248
16	New Jersey	$57	+9%	BCBS	Aetna	225
17	Maine	$57	+8%	UHC	Aetna	215
18	Idaho	$57	+7%	UHC	Aetna	167
19	Colorado	$56	+7%	UHC	Aetna	241
20	District of Columbia	$56	+5%	UHC	BCBS	162
21	Pennsylvania	$55	+5%	UHC	Aetna	206
22	Rhode Island	$55	+5%	UHC	Aetna	188
23	Iowa	$55	+4%	UHC	Aetna	211
24	California	$55	+4%	UHC	Aetna	204
25	New Mexico	$55	+4%	UHC	Aetna	183
26	Wyoming	$53	+0%	UHC	Aetna	124
27	Ohio	$52	-1%	UHC	Aetna	236
28	South Carolina	$51	-4%	BCBS	Aetna	216
29	Oklahoma	$50	-5%	UHC	Aetna	227
30	New York	$50	-6%	UHC	Aetna	236
31	West Virginia	$50	-6%	UHC	Aetna	193
32	Illinois	$49	-7%	UHC	Aetna	206
33	Delaware	$49	-7%	UHC	Aetna	179
34	Kansas	$48	-9%	UHC	Aetna	230
35	Utah	$48	-9%	UHC	Aetna	204
36	Missouri	$48	-10%	UHC	Aetna	234
37	Tennessee	$47	-11%	UHC	Aetna	227
38	Montana	$47	-12%	UHC	Aetna	149
39	Arkansas	$47	-12%	UHC	Aetna	239
40	Mississippi	$47	-12%	UHC	Aetna	231
41	Virginia	$47	-12%	UHC	Aetna	219
42	Kentucky	$45	-14%	UHC	Aetna	253
43	Louisiana	$44	-16%	UHC	Aetna	215
44	Nevada	$44	-17%	UHC	Aetna	222
45	Michigan	$44	-18%	UHC	Aetna	223
46	Florida	$43	-19%	UHC	Aetna	213
47	Texas	$43	-19%	UHC	BCBS	249
48	Indiana	$42	-21%	UHC	Aetna	245
49	Maryland	$41	-22%	UHC	Aetna	205
50	Arizona	$39	-27%	UHC	Aetna	192
51	Alabama	$34	-36%	UHC	Aetna	228

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 99457?

In the files we analyzed, UnitedHealthcare, at a median of $73 across 8,550 sampled providers. Aetna is lowest at $31, 137% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 102% of the 2026 Medicare non-facility rate of $51.77.

Which state has the highest median for CPT 99457?

Alaska has the highest median at $102; Alabama has the lowest at $34.

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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