What do payers pay cardiology groups in GA?

Across 720 NPIs, the median published rate is 142.7% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 68 procedure codes and 3 payers, the median published rate is 224 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 249 percent and Aetna the lowest at 191 percent, a spread of 58 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 720 confirmed NPIs, and any combination under five is withheld rather than shown thin. These are contracted amounts the payer published, not what a practice was paid, and every row clears the ghost-rate filter, so each NPI counted here actually billed the code in the Medicare utilization file.

Published rates

What do payers pay cardiology groups in GA?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
Cigna	99214	professional	720	149.92	196.62	208.99	142.7%
UnitedHealthcare	99214	professional	702	147.36	188.48	202.49	142.3%
Cigna	93000	professional	640	29.11	37.04	42.12	236.5%
UnitedHealthcare	93000	professional	623	29.47	36.07	55.66	230.3%
Cigna	93306	professional	621	197.36	275.19	396.83	244.3%
Aetna	99214	professional	615	36	82.81	172.7	89.3%
UnitedHealthcare	93306	professional	605	183.37	295.13	448.26	264.6%
Cigna	99204	professional	588	221.62	279.32	324.26	156.2%
UnitedHealthcare	99204	professional	570	229.78	295.37	309.87	163.6%
Aetna	93000	professional	562	6.79	17.12	30.75	196.2%
Aetna	93306	professional	542	135.82	208.8	342.71	196.2%
Aetna	99204	professional	515	36	118.19	254.13	103.1%
Cigna	93010	professional	490	14.26	17.5	23.52	214.2%
UnitedHealthcare	93010	professional	471	15.77	19.51	24.52	230.3%
Cigna	78452	professional	453	182.17	637.46	874.86	202.2%
UnitedHealthcare	78452	professional	438	200.93	674.29	1038.92	244.6%
Cigna	99213	professional	422	93.67	134.01	145.14	139.5%
UnitedHealthcare	99213	professional	420	91.55	126.83	138.94	139.9%
Aetna	78452	professional	409	171.44	429.17	787.94	194.6%
Aetna	93010	professional	402	3.8	9.1	16.18	189.1%
Cigna	93018	professional	393	24.45	27.88	37.15	207.4%
UnitedHealthcare	93018	professional	376	27.59	36.66	42.54	264.7%
Cigna	99215	professional	365	221	283.99	301.97	146.9%
Aetna	99213	professional	363	31.35	62.62	107.47	86.7%
UnitedHealthcare	99215	professional	350	236.27	275.96	292.84	144.5%
Cigna	93308	professional	343	71.4	150.04	217.1	217.6%
Aetna	93018	professional	339	6.65	16.2	27.74	200.3%
Cigna	93016	professional	335	37.3	41.85	56.11	207.6%
UnitedHealthcare	93308	professional	325	76.01	160.83	248.94	267.5%
UnitedHealthcare	93016	professional	322	40.86	55.94	64.59	267.5%
Aetna	99215	professional	309	39.98	118.59	252.27	105.4%
Aetna	93308	professional	299	46.61	66.65	154	194.4%
Aetna	93016	professional	291	9.97	24.76	41.84	199%
Cigna	93325	professional	278	8.78	41	59.32	224.6%
UnitedHealthcare	93325	professional	259	9.21	45.92	64.37	267.5%
Cigna	93458	professional	242	788.19	1416.81	1998.21	222.4%
UnitedHealthcare	93015	professional	239	131.27	167.38	241.68	225%
UnitedHealthcare	93458	professional	239	866.56	1467.84	2313.16	245.2%
Cigna	93015	professional	238	140.42	187.9	195.3	251.9%
Cigna	93228	professional	235	40.22	58.51	70.16	240.4%
Aetna	93325	professional	234	6.49	25.66	48.08	203.5%
Aetna	93458	professional	228	699.96	1019.4	1681.86	190.1%
Aetna	93015	professional	226	32.59	110.33	143.29	192%
UnitedHealthcare	93228	professional	217	49.91	54.56	68.03	224.1%
Cigna	93312	professional	205	225.96	333.52	475.89	218.7%
Aetna	93228	professional	201	45.89	53.66	54.01	196.2%
Cigna	93321	professional	196	22.05	36.29	52.51	208.7%
Cigna	93356	professional	196	58.33	61.06	93.49	163.5%
UnitedHealthcare	93312	professional	194	251.85	348.73	471.53	267.5%
Cigna	93880	professional	191	91.2	287.56	418.36	228.7%
Cigna	99205	professional	189	314.74	355.33	434.17	154.9%
UnitedHealthcare	99205	professional	183	309.94	378.76	415.4	160.7%
UnitedHealthcare	93321	professional	179	21.25	44.64	57.6	267.5%
UnitedHealthcare	93880	professional	178	112	287.09	407.94	210.1%
UnitedHealthcare	93356	professional	176	48.24	50.35	86.86	134.9%
Aetna	93312	professional	175	56.39	171.7	278.24	195.9%
Cigna	92960	professional	164	245.23	333.78	374.84	212.3%
Aetna	99205	professional	164	38.46	150.2	329.12	92.6%
Aetna	93880	professional	161	67.21	168.02	317.42	189.2%
Aetna	93321	professional	157	12.77	23.87	42.2	199.4%
UnitedHealthcare	92960	professional	156	250.45	386.17	430.62	245.7%
Cigna	93280	professional	151	62.58	97.27	120.54	200.2%
UnitedHealthcare	93280	professional	151	66.05	95	130.91	194.3%
Aetna	93356	professional	147	12.11	29.04	47.2	101.9%
Cigna	93294	professional	144	52.03	68	79.03	236.6%
Cigna	93320	professional	144	46.16	67.29	102.41	210%
UnitedHealthcare	93294	professional	142	55.56	61.52	86.38	212%
UnitedHealthcare	93320	professional	142	52.67	88.73	119.41	288.6%
Cigna	92928	professional	140	1008.24	1201.56	1581.23	254.5%
UnitedHealthcare	92928	professional	140	1031.49	1195.71	1735.02	257.4%
Aetna	93280	professional	139	39.87	67.2	93.18	159.9%
Aetna	92960	professional	138	30.87	66.63	171.83	150.1%
Aetna	92928	professional	136	107.16	403.66	772.93	193.9%
Aetna	93294	professional	133	34.63	55.29	73.14	191.1%
Aetna	93320	professional	128	34.34	53.71	87.35	195.7%
Cigna	92978	professional	111	253.2	356.53	601.57	251.7%
UnitedHealthcare	92978	professional	105	277.37	540.56	889.33	264.7%
Cigna	93295	professional	104	78.5	98.11	119.53	267.7%
UnitedHealthcare	93295	professional	103	71.58	92.56	112.11	262.4%
Aetna	92978	professional	97	150.09	203.91	307.69	188.3%
UnitedHealthcare	93272	professional	97	50.7	72.91	85.17	303.8%
Cigna	93272	professional	96	48	53.16	64.36	225.4%
Cigna	93298	professional	94	49.34	88.86	194.78	194.6%
Aetna	93295	professional	93	41.32	75.42	96.98	205.8%
Cigna	93296	professional	93	44.19	51.42	57.79	178.3%
UnitedHealthcare	93298	professional	93	56.82	90.5	239.18	230.3%
Cigna	93248	professional	91	46.25	50.69	54.42	202.7%
UnitedHealthcare	93248	professional	90	44.09	59.9	79.99	245.2%
Aetna	93272	professional	90	13.2	47.55	64.12	201.6%
UnitedHealthcare	93296	professional	90	47.22	57.8	66.03	202.2%
Aetna	93296	professional	85	27.19	48.93	64.89	151.5%
Aetna	93298	professional	85	15.35	28.32	48.57	46.9%
UnitedHealthcare	93227	professional	83	47.58	56.72	64.68	328.6%
Cigna	99203	professional	83	115.72	175.6	208.19	155.8%
Cigna	93227	professional	82	36.46	48.88	50.39	273.3%
Aetna	93248	professional	82	12.35	25.08	29.62	118.5%
UnitedHealthcare	33208	professional	81	1035.23	1168.79	1734.43	247.8%
UnitedHealthcare	99203	professional	81	130.5	172.39	198.15	150.4%
Cigna	33208	professional	80	941.64	1171.26	1301.33	256.7%
Cigna	93244	professional	80	42.18	51.58	61.64	232.1%
UnitedHealthcare	93244	professional	78	42.95	58.38	76.27	262.6%
Aetna	33208	professional	77	78.89	295.39	632.19	227.4%
Cigna	93284	professional	77	107.64	148.81	198.47	258.5%
UnitedHealthcare	93284	professional	76	110.54	141.22	184.44	230.3%
Aetna	99203	professional	71	33	70.73	134.97	85.8%
Aetna	93227	professional	70	8.56	20.78	44.99	251.9%
Aetna	93244	professional	68	11.24	22.47	42.29	183.8%
Cigna	93970	professional	68	80.44	356.67	434.11	243.1%
Aetna	93284	professional	67	70.78	107.37	160.32	180.5%
Cigna	93279	professional	65	67.37	91.61	118.85	246.8%
Cigna	93283	professional	65	100.57	138.82	186.07	253.7%
UnitedHealthcare	93279	professional	64	65.7	94.18	113.41	230.3%
UnitedHealthcare	93283	professional	64	106.03	131.94	189.51	230.3%
Cigna	75574	professional	63	346.97	582.62	887.91	294.9%
UnitedHealthcare	93656	professional	63	2042.57	2520.07	3180.33	302.7%
Cigna	93656	professional	61	1800.08	2545.42	3136.42	304.3%
Cigna	93925	professional	61	92.85	361.68	555.74	230%
Aetna	93656	professional	60	205.62	771.08	1824.56	258.2%
UnitedHealthcare	93970	professional	60	89.56	287.72	368.96	215.3%
UnitedHealthcare	93925	professional	59	115.49	380.06	507.77	204%
UnitedHealthcare	75574	professional	58	300.88	531.29	628.57	249.4%
UnitedHealthcare	93288	professional	56	42.74	63.78	99.94	204.7%
Aetna	93460	professional	56	897.59	1185.26	2200.58	180.6%
Aetna	93925	professional	55	74.19	230.48	401.09	178.1%
Aetna	93283	professional	54	72.03	106.4	147.42	194.8%
Cigna	93288	professional	54	40.55	64.41	97.43	201.7%
Aetna	93459	professional	54	803.46	1206.81	2123.17	195.4%
Cigna	93270	professional	53	12.37	22.65	24.3	1095.6%
UnitedHealthcare	93270	professional	53	14.4	28.02	29.97	350.7%
Cigna	93281	professional	53	94.27	116.35	167.4	265.9%
Cigna	93460	professional	53	998.13	1736.39	2521.63	256.4%
Aetna	93279	professional	52	54.73	78.4	85.2	207.4%
UnitedHealthcare	93460	professional	52	1086.68	1657.57	2999.54	270.6%
UnitedHealthcare	93281	professional	51	94.96	125.27	161.82	265.8%
Cigna	93459	professional	51	1014.23	1578.94	2369.64	265.6%
Aetna	75574	professional	50	220	271.66	499.86	182.4%
Aetna	93270	professional	50	8.28	14.99	23.66	276.9%
Aetna	93288	professional	50	33.25	50.87	76.64	141.1%
UnitedHealthcare	93459	professional	50	1028.19	1749.9	2786.8	306.6%
Aetna	93970	professional	50	67.1	172.83	283.17	155%
Cigna	93225	professional	49	46.29	49.68	52.01	326.6%
UnitedHealthcare	93225	professional	49	47.22	49.72	65.76	270.4%
UnitedHealthcare	93229	professional	49	1643.92	2306.39	2724.3	340.5%
Cigna	93229	professional	48	1775.2	1969.28	2201.42	262.1%
Cigna	93297	professional	48	43.53	66.16	97.43	193.4%
Aetna	93297	professional	47	18.15	28.42	45.4	84.3%
UnitedHealthcare	93297	professional	47	55.3	75.62	111.33	300.5%
Aetna	93454	professional	47	616.1	890.98	1629.16	185%
Cigna	93571	professional	47	205.73	354.68	547.23	201%
Aetna	93229	professional	46	1192.98	1442.55	1795.18	222.2%
Cigna	93922	professional	46	32.38	164.68	192.46	232.3%
UnitedHealthcare	93922	professional	46	36.53	140.38	194.1	222.4%
Cigna	93282	professional	45	78.88	108.71	153.85	265.9%
UnitedHealthcare	93454	professional	45	707.36	1260.57	1976.48	263.7%
Cigna	78492	professional	44	257.34	1657.12	2334.76	251.7%
Aetna	93281	professional	44	77.23	94.96	130.47	216.4%
UnitedHealthcare	93282	professional	44	81.04	106.05	141.56	230.3%
Cigna	93246	professional	43	18.62	26.11	32.56	248%
UnitedHealthcare	93246	professional	42	21.56	29.48	31.82	267.5%
Cigna	93350	professional	42	192.49	248.82	374.57	217.1%
UnitedHealthcare	93571	professional	42	221.75	277.84	532.69	239.1%
Cigna	33340	professional	41	1239.04	1572.15	1994.43	246.2%
UnitedHealthcare	33340	professional	41	1483.7	1771.49	2175.94	277.4%
Aetna	93922	professional	41	30.56	95.15	141.23	166.8%
UnitedHealthcare	93350	professional	40	204.57	268.9	422.48	270.4%
Cigna	93454	professional	40	638.54	1153.95	1734.45	201.7%
Aetna	33340	professional	39	139.29	444.55	889.09	224.2%
Aetna	93225	professional	39	18.49	35.26	48.26	247.8%
Cigna	93242	professional	39	23.46	32.32	36.74	273.3%
Aetna	93571	professional	39	114.46	177.02	254.23	145.6%
Aetna	93350	professional	38	78.89	160.17	268.78	195.8%
UnitedHealthcare	93655	professional	38	664.09	957.2	1139.86	353.8%
Aetna	78492	professional	37	243.12	609.8	1573.57	465.6%
UnitedHealthcare	93242	professional	37	28.72	31.56	34.22	272.8%
Aetna	93246	professional	37	5.9	11.8	16.77	146.5%
Aetna	93282	professional	37	54.6	83.09	109.02	173.3%
Cigna	93655	professional	37	613.62	730.22	850.84	275.8%
Aetna	93653	professional	36	146.61	498.88	1326.25	179.8%
UnitedHealthcare	93653	professional	36	1663.56	1839.04	2286.41	249.3%
UnitedHealthcare	78492	professional	35	155.73	904.33	2803.81	168.2%
Cigna	33361	professional	34	2315.46	2978.01	3522.12	270.8%
Cigna	93224	professional	34	180.86	195.09	195.09	272.4%
UnitedHealthcare	93224	professional	34	166.5	209.45	258.23	319.5%
Cigna	93971	professional	34	52.34	200.05	277.88	243.1%
UnitedHealthcare	33361	professional	33	2466.39	3365.58	4386.48	310.2%
Aetna	93224	professional	33	65.72	121.96	214.16	299%
Cigna	93653	professional	33	1323.89	2133.34	2317.25	289.2%
Cigna	33225	professional	32	929.97	1118.44	1293.75	276.4%
Aetna	93242	professional	31	4.63	8.39	19.87	190.6%
Cigna	93793	professional	31	19.82	28.38	30.02	253.9%
UnitedHealthcare	33225	professional	30	1004.09	1295.32	1641.52	316.7%
Aetna	33249	professional	29	156.23	562.85	1535.3	161.2%
Aetna	93655	professional	29	74.84	283.37	646.08	304.2%
UnitedHealthcare	93657	professional	28	727.03	956.43	1174.79	353.5%
Aetna	33225	professional	27	109.59	396.72	821.92	249%
UnitedHealthcare	33249	professional	27	1897.6	2514.67	3052.7	305.9%
Aetna	33361	professional	27	242.2	838.4	1739.31	240.6%
Cigna	93657	professional	27	604.77	645.4	827.42	238.5%
UnitedHealthcare	93793	professional	27	21.51	22.83	35.22	204.3%
UnitedHealthcare	93971	professional	27	60.21	185.07	272.25	222.6%

Median rate by payer, percent of Medicare

Solid line 100% of Medicare.

How this is measured

Rates come from each payer's published Transparency in Coverage machine-readable file, filtered to this specialty's codes and to NPIs the CMS Medicare utilization file shows billing that code. Percentiles are computed per payer, code and site of service across those NPIs, then divided by the locality-adjusted Medicare amount for the same code and place. Full methodology.

Payer files: 2026-09

Questions

Is this what the practice was paid?

No. These are contracted rates as published by the payer, not allowed or paid amounts.

Why are some cells blank?

Ghost rates are removed using Medicare utilization. A row appears only if that NPI billed the code.

What is an episode total?

Professional plus facility when both exist. We never average them or invent a total from one side.

Saran Siva

Co-founder & CTO, Insight Health · September 2026 files