Cardiology · specialty benchmark

Cardiology commercial reimbursement benchmarks

What commercial payers pay for the procedures that matter most to cardiology practices.

Cardiology at a glance

5,085 sampled providers

Codes tracked

publishable codes

Median % of Medicare

150%

across codes

Highest state

Alaska

Highest payer

UHC

UnitedHealthcare

Cardiology rates in this dataset cover 38 procedure codes and 5,085 sampled providers in 51 states, at a median 150% of Medicare.

Alaska has the highest cardiology index and Arizona the lowest.

UnitedHealthcare has the highest cardiology index and Aetna the lowest.

The biggest revenue code by Medicare allowed dollars is CPT 99214 (Office o/p est mod 30 min), paid at a 131-dollar median, 97% of Medicare.

Ranked by Medicare allowed dollars billed by the specialty

Rank	Code	Median	Medicare	% of Medicare	Providers
1	CPT 99214 Office o/p est mod 30 min	$131	$135.61	97%	5,065
2	CPT 93306 Tte w/doppler complete	$317	$196.73	161%	5,045
3	CPT 78452 Ht muscle image spect mult	$609	$427.87	142%	5,040
4	CPT 99215 Office o/p est hi 40 min	$185	$192.39	96%	5,063
7	CPT 99213 Office o/p est low 20 min	$91	$95.19	95%	5,066
8	CPT 99204 Office o/p new mod 45 min	$192	$177.36	108%	5,067
10	CPT 93880 Extracranial bilat study	$283	$189.05	150%	5,046
11	CPT 93000 Electrocardiogram complete	$25	$15.36	165%	5,032
12	CPT 93229 Remote 30 day ecg tech supp	$1,088	$758.53	143%	5,014
14	CPT 93010 Electrocardiogram report	$13	$8.35	151%	5,026

Index: 100 = four-payer median for the specialty's codes

Payer	Index	Rank	Highest on
UnitedHealthcare	114	1	82%
Cigna	106	2	10%
Blue Cross Blue Shield	99	3	8%
Aetna	78	4	0%

Index: 100 = the specialty's national median

Rank	State	Index	Codes	Providers
1	Alaska	251	38	28
2	Wisconsin	145	38	108
3	Minnesota	141	38	102
4	Oregon	140	38	92
5	Washington	139	38	110
6	Georgia	138	38	129
7	North Dakota	135	38	30
8	Connecticut	134	38	119
9	Massachusetts	133	38	109
10	New Hampshire	127	38	117
11	Nebraska	126	38	81
12	South Dakota	125	38	34
13	District of Columbia	125	38	80
14	Wyoming	124	38	20
15	Iowa	122	38	113
16	North Carolina	118	38	127
17	Rhode Island	107	38	91
18	Idaho	106	38	63
19	Vermont	106	38	28
20	Utah	105	38	99
21	Ohio	103	38	117
22	Montana	102	38	49
23	Kansas	102	38	121
24	New Jersey	101	38	113
25	Missouri	100	38	120
26	Colorado	99	38	129
27	Illinois	98	38	119
28	Tennessee	98	38	123
29	Pennsylvania	98	38	98
30	Maine	97	38	100
31	Kentucky	96	38	128
32	Hawaii	94	38	57
33	Mississippi	94	38	132
34	New Mexico	93	38	85
35	Arkansas	93	38	120
36	Oklahoma	90	38	119
37	Maryland	90	38	112
38	Michigan	90	38	124
39	South Carolina	89	38	117
40	California	89	38	108
41	West Virginia	88	38	80
42	Indiana	88	38	122
43	New York	88	38	123
44	Alabama	87	38	127
45	Virginia	87	38	123
46	Louisiana	82	38	111
47	Delaware	81	38	72
48	Texas	80	38	131
49	Florida	78	38	111
50	Nevada	76	38	116
51	Arizona	69	38	98

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 negotiated rates compare by code, payer and state.