Cigna · payer overview

Cigna negotiated rates by state and specialty

Where Cigna pays above and below the market, from its published in-network files.

Cigna at a glance

228 codes · 51 states · 31,313 sampled providers · source: Cigna national PPO
Rate index
102
100 = four-payer median
Payer rank
2 of 4
1 = highest
Median % of Medicare
161%
across tracked codes
Highest on
18%
of codes

What the data shows

1

Cigna ranks 2nd of 4 payers with a rate index of 102 (100 = four-payer median) across 228 procedure codes.

2

Its median rate is 161% of Medicare, and it has the highest median on 18% of codes in the files analyzed.

3

Strongest market: Michigan (index 123 vs that state's market); weakest: Alaska (64).

4

Largest premium over the market: CPT 51798 (Us urine capacity measure) at 143% of market.

5

By specialty it is strongest for internal medicine (ranks 2nd of 4 payers).

Cigna by state

Index vs the state market; own-national index vs the payer's national level
StateIndex vs marketRank in statevs own nationalLevelProviders
Michigan1231 of 4106
93
District of Columbia1212 of 4132
430
New York1202 of 4114
672
Iowa1172 of 4141
604
Nebraska1142 of 4151
551
New Mexico1122 of 4105
464
California1122 of 4100
648
Kentucky1112 of 497
848
Rhode Island1102 of 4107
562
West Virginia1102 of 499
518
Maryland1102 of 495
723
Massachusetts1092 of 4133
808
Vermont1092 of 4115
302
Texas1082 of 487
822
Connecticut1072 of 4131
855
Illinois1062 of 4100
644
Georgia1052 of 4136
829
New Hampshire1052 of 4129
665
New Jersey1042 of 4101
795
South Dakota1032 of 4141
286
North Carolina1032 of 4112
851
Indiana1032 of 486
812
Virginia1022 of 494
787
Arizona1022 of 482
698
Minnesota1023 of 498
169
Kansas1012 of 497
674
Oregon1002 of 4152
735
Delaware1002 of 482
392
Nevada1003 of 485
657
Oklahoma1002 of 480
748
Hawaii1002 of 4100
413
South Carolina1003 of 490
778
Montana1003 of 4100
367
Maine1003 of 4103
597
Arkansas1002 of 493
717
Washington992 of 4128
749
Idaho974 of 4100
529
Tennessee973 of 493
850
Florida963 of 475
775
Missouri963 of 487
849
Louisiana953 of 483
837
Ohio953 of 494
806
Utah943 of 491
751
Colorado943 of 495
752
Pennsylvania943 of 486
788
Mississippi894 of 4100
702
Alabama864 of 472
837
Wyoming833 of 4106
150
North Dakota813 of 499
71
Wisconsin673 of 4108
296
Alaska644 of 4108
57

Cigna by specialty

Index vs the four-payer median for the specialty's codes
SpecialtyIndexRank of 4Highest onProviders
Internal medicine1042 of 48%4,182
Urology1032 of 416%3,400
Diagnostic radiology1082 of 437%4,669
Cardiology1062 of 410%4,088
Orthopedic surgery1023 of 418%4,050
Ophthalmology1003 of 410%3,784
Gastroenterology1003 of 40%3,606
Dermatology973 of 40%3,534

Where Cigna pays most and least against the market

Highest above market

CodeCignavs market
51798
Us urine capacity measure
$31+43%
76872
Us transrectal
$232+23%
70496
Ct angiography head
$535+17%
70498
Ct angiography neck
$537+17%
74183
Mri abd w/o cntr flwd cntr
$734+16%
77080
Dxa bone density axial
$77+16%
72197
Mri pelvis w/o & w/dye
$730+15%
92250
Fundus photography w/i&r
$60+14%

Furthest below market

CodeCignavs market
88342
Imhchem/imcytchm 1st antb
$66-31%
88312
Special stains group 1
$68-30%
88313
Special stains group 2
$53-25%
43239
Egd biopsy single/multiple
$277-21%
88305
Tissue exam by pathologist
$56-20%
52332
Cystoscopy and treatment
$294-18%
52224
Cystoscopy and treatment
$379-17%
11104
Punch bx skin single lesion
$67-17%

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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