CPT 99490 · professional fee

Chrnc care mgmt staff 1st 20 (CPT 99490): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 99490, from their published in-network rate files.

Urology Internal medicineSnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$60

P10 to P90: $39 to $116

vs Medicare

91%

non-facility rate $66.13

Payer spread

1.50×

BCBS $66 vs Aetna $44

State spread

3.0×

AK $122 to AL $41

19,034 sampled providers17,567 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Blue Cross Blue Shield has the highest median for CPT 99490 in the files analyzed, at $66, 50% above Aetna ($44), the lowest of the 4 payers shown.

The state spread is 3.0×: Alaska has the highest median at $122 and Alabama the lowest at $41, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 91% of the Medicare non-facility rate ($66.13), which ranks 217th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $14) and widest within UnitedHealthcare ($39).

This is a top-7 code for urology 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
Blue Cross Blue Shield	$66	$51	$85	+10%	1	14,579	100% of Medicare
UnitedHealthcare	$66	$50	$89	+9%	2	15,898	99% of Medicare
Cigna	$61	$48	$84	+2%	3	15,171	92% of Medicare
Aetna	$44	$37	$52	-27%	4	8,538	67% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($66.13)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$122	+103%	BCBS	Cigna	161
2	Oregon	$121	+101%	UHC	Aetna	396
3	Minnesota	$99	+65%	UHC	Aetna	412
4	Washington	$97	+61%	UHC	Aetna	423
5	New Hampshire	$95	+57%	UHC	Aetna	345
6	Wisconsin	$94	+56%	UHC	Aetna	434
7	North Dakota	$92	+53%	BCBS	Aetna	179
8	Nebraska	$87	+45%	Cigna	Aetna	265
9	Massachusetts	$86	+44%	UHC	Aetna	439
10	Wyoming	$81	+35%	BCBS	Aetna	146
11	Hawaii	$79	+32%	Cigna	Aetna	199
12	Montana	$78	+30%	Cigna	Aetna	216
13	District of Columbia	$77	+28%	Aetna	BCBS	260
14	Colorado	$74	+22%	BCBS	Aetna	476
15	Connecticut	$72	+20%	BCBS	Aetna	473
16	Iowa	$70	+15%	Cigna	Aetna	348
17	North Carolina	$68	+12%	UHC	Aetna	497
18	South Dakota	$67	+11%	BCBS	Aetna	215
19	Georgia	$64	+7%	UHC	Aetna	493
20	Vermont	$64	+7%	UHC	Aetna	176
21	Idaho	$64	+7%	BCBS	Cigna	267
22	Maine	$64	+6%	Cigna	Aetna	319
23	Illinois	$63	+4%	Cigna	Aetna	428
24	California	$62	+4%	UHC	Aetna	406
25	Ohio	$62	+3%	UHC	Aetna	465
26	Pennsylvania	$61	+1%	UHC	Aetna	428
27	Virginia	$60	+0%	BCBS	Aetna	439
28	Michigan	$59	-1%	BCBS	UHC	425
29	New Jersey	$59	-2%	BCBS	Aetna	446
30	New Mexico	$59	-3%	UHC	Aetna	277
31	Tennessee	$58	-3%	BCBS	Aetna	445
32	Rhode Island	$58	-4%	UHC	Aetna	294
33	Utah	$57	-5%	UHC	Aetna	369
34	New York	$57	-5%	UHC	Aetna	482
35	South Carolina	$56	-6%	UHC	Aetna	430
36	West Virginia	$55	-8%	UHC	Aetna	290
37	Maryland	$55	-8%	Cigna	Aetna	415
38	Indiana	$54	-10%	BCBS	Aetna	477
39	Oklahoma	$53	-11%	UHC	Aetna	433
40	Delaware	$53	-12%	Cigna	Aetna	237
41	Kansas	$52	-13%	UHC	Aetna	361
42	Missouri	$52	-14%	Cigna	Aetna	482
43	Texas	$51	-15%	Cigna	BCBS	507
44	Florida	$50	-17%	UHC	Aetna	443
45	Nevada	$49	-18%	BCBS	Aetna	362
46	Kentucky	$49	-19%	Cigna	BCBS	494
47	Arizona	$48	-20%	UHC	Aetna	388
48	Mississippi	$48	-21%	BCBS	Cigna	388
49	Louisiana	$47	-22%	UHC	Aetna	437
50	Arkansas	$45	-25%	UHC	Aetna	385
51	Alabama	$41	-32%	UHC	Cigna	462

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 99490?

In the files we analyzed, Blue Cross Blue Shield, at a median of $66 across 14,579 sampled providers. Aetna is lowest at $44, 50% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 91% of the 2026 Medicare non-facility rate of $66.13.

Which state has the highest median for CPT 99490?

Alaska has the highest median at $122; Alabama has the lowest at $41.

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 99490

Benchmark your negotiated rates for 99490 and the rest of your book against these payer and state medians.

Request a rate benchmark