What do payers pay cardiology groups in NC?

Across 738 NPIs, the median published rate is 137.2% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 75 procedure codes and 3 payers, the median published rate is 199 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 270 percent and Aetna the lowest at 133 percent, a spread of 137 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 738 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 NC?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
Cigna	99214	professional	738	141.98	177.6	188.09	137.2%
UnitedHealthcare	99214	professional	699	149.35	182.68	222.01	141.1%
Cigna	93306	professional	594	155.05	260.31	359.12	207.8%
Cigna	99204	professional	589	211.21	238.37	293.8	141.1%
UnitedHealthcare	93306	professional	561	187.45	298.26	431.76	280%
UnitedHealthcare	99204	professional	558	223.2	290.49	295.23	172%
Cigna	93000	professional	496	27.33	30.48	37.43	209.9%
Cigna	93010	professional	489	14.02	15.23	17.82	188.7%
UnitedHealthcare	93000	professional	463	28.61	35.37	40.87	243.6%
UnitedHealthcare	93010	professional	461	14.9	20.25	22.65	250.8%
Cigna	99215	professional	449	201.69	256.65	276.09	139.7%
UnitedHealthcare	99215	professional	422	219.27	250.27	317.61	136.2%
Cigna	78452	professional	385	171.49	609.99	769.99	191.8%
Cigna	99213	professional	374	85.34	111.58	125.11	122.8%
Aetna	99214	professional	365	30.45	56.23	115.4	78.1%
UnitedHealthcare	78452	professional	359	216.17	647.94	886.08	205.6%
UnitedHealthcare	99213	professional	354	89.36	115.57	152.96	127.4%
Cigna	93018	professional	349	23.74	26.63	32.11	199.8%
Cigna	93308	professional	338	60.73	132.71	193.99	205.3%
UnitedHealthcare	93018	professional	335	24.69	37.61	44.73	282.2%
Cigna	93325	professional	332	8.34	42.07	56.53	223.4%
UnitedHealthcare	93325	professional	315	10.45	49.32	66.71	279.9%
UnitedHealthcare	93308	professional	314	80.24	165.45	257.04	272.7%
Aetna	93306	professional	306	109.06	168.18	239.75	136%
Aetna	99204	professional	287	30	73.86	168.16	95.3%
Cigna	93016	professional	278	36.91	39.62	46.88	196.1%
UnitedHealthcare	93016	professional	277	42.32	56.97	67.02	281.9%
Cigna	93356	professional	256	40.66	46.71	60.19	135%
Aetna	93000	professional	255	6.92	15.22	23.05	131.6%
UnitedHealthcare	93356	professional	255	50.13	64.43	76.07	186.2%
Cigna	99205	professional	244	286.03	321.66	380.04	142.8%
Aetna	93010	professional	228	4.05	8.09	11.22	131.9%
Cigna	93248	professional	226	45.69	51.13	66.85	212.4%
UnitedHealthcare	99205	professional	225	308.33	368.39	394.73	163.6%
UnitedHealthcare	93248	professional	218	48.26	68.14	89.83	283.1%
Cigna	93321	professional	214	19.27	38.34	52.5	223.4%
UnitedHealthcare	93321	professional	213	24.06	47.09	66.22	279.8%
Cigna	93312	professional	209	221.5	288.33	434.11	207.4%
Aetna	99213	professional	209	30.9	53.08	81.67	83.9%
Cigna	93458	professional	207	627	1332.76	1864.25	197.8%
Aetna	99215	professional	203	30	79.69	162.86	82.7%
UnitedHealthcare	93458	professional	199	824.18	1385.9	2148.85	243.3%
Cigna	93228	professional	195	45.67	47.11	52.4	195.2%
Cigna	93244	professional	195	43.86	46.52	64.51	210.6%
UnitedHealthcare	93312	professional	194	285.35	359.36	498.1	276.6%
Aetna	78452	professional	191	115.06	354.84	469.19	116.7%
UnitedHealthcare	93244	professional	191	48.81	62.32	79.36	282.1%
Cigna	92960	professional	189	234.37	260.42	379.07	176.9%
Cigna	93294	professional	179	55.05	57.71	67.37	203.6%
Cigna	93320	professional	179	41.28	68.07	95.66	214.4%
Cigna	93015	professional	178	123	143.45	156.1	205.5%
Aetna	93018	professional	177	7.1	14.98	19.87	137.9%
UnitedHealthcare	93228	professional	177	46.52	67.16	67.16	278.3%
UnitedHealthcare	92960	professional	175	279.98	349.15	440.67	237.2%
Cigna	93280	professional	167	60.25	76.87	116.81	187.6%
UnitedHealthcare	93294	professional	167	55.63	65.5	84.05	231%
Aetna	93308	professional	163	32.75	49.95	106.23	133.8%
UnitedHealthcare	93320	professional	162	50.59	82	112.25	274.5%
UnitedHealthcare	93280	professional	154	64.91	96.41	125.38	195.3%
UnitedHealthcare	93015	professional	153	120.03	161.48	235.29	241.4%
Cigna	93246	professional	146	19.24	26.25	32.79	252.7%
UnitedHealthcare	93246	professional	139	25.92	31.34	44.67	289.9%
Cigna	93296	professional	134	40.97	46.02	54.97	156%
Cigna	93880	professional	134	79.86	269.31	344.95	194.7%
Aetna	93325	professional	132	5.32	22.08	39.19	144.8%
Aetna	93016	professional	131	10.64	22.66	28.2	136.4%
Cigna	92928	professional	126	954.34	1080.5	1356.38	250.1%
UnitedHealthcare	93296	professional	124	46.57	51.46	61.3	174.4%
UnitedHealthcare	92928	professional	122	963.35	1246.69	1669.67	311.3%
Aetna	93356	professional	120	17.85	24.29	44.64	105.5%
Cigna	93295	professional	119	75.34	89.18	124.49	256.4%
UnitedHealthcare	93880	professional	119	104.41	283.33	406.6	234.3%
Aetna	93458	professional	118	450.12	897.85	1177.47	133.2%
Cigna	93242	professional	116	20.92	27.31	33.64	253.5%
Aetna	99205	professional	115	30	98.82	216.2	83.7%
Cigna	93351	professional	114	191.82	303.68	424.49	214.3%
UnitedHealthcare	93295	professional	113	85.59	101.72	117.49	292.5%
Cigna	93298	professional	113	49.01	70.44	138.59	188.9%
UnitedHealthcare	93242	professional	111	28.01	33.75	43.3	312.2%
UnitedHealthcare	93298	professional	108	56.64	66.89	186.91	86%
Aetna	93312	professional	106	47.72	139.26	229.92	136.7%
UnitedHealthcare	93351	professional	103	278.47	395.06	561.53	279.5%
Aetna	93248	professional	99	13.17	27.13	33.42	130.2%
Cigna	33208	professional	92	895.03	944.98	1199.65	222.5%
Aetna	93244	professional	91	11.99	23.97	30.56	129.1%
Aetna	93321	professional	91	11.35	18.74	32.47	153.6%
Cigna	92978	professional	90	215.92	306.64	477.85	201.7%
UnitedHealthcare	33208	professional	89	978.91	1223.67	1849.67	288%
Cigna	93793	professional	89	18.18	21.33	22.95	190.2%
UnitedHealthcare	93793	professional	88	24.21	31.18	38.5	278.1%
Aetna	93015	professional	87	48.25	82.43	113.18	139.2%
UnitedHealthcare	92978	professional	85	244.94	362.42	569.18	247.1%
Aetna	93228	professional	85	25.13	29.93	37.38	119.4%
Cigna	99203	professional	85	107.63	144.06	184.06	129%
UnitedHealthcare	99203	professional	84	126.29	155.72	201.04	139.4%
Cigna	75574	professional	83	277.19	494.2	702.35	239.1%
UnitedHealthcare	75574	professional	78	279.39	487.44	651.48	252.8%
Cigna	93922	professional	77	24.89	126.2	149.38	195.2%
Cigna	93017	professional	76	62.29	71.72	86.82	293.7%
Cigna	93284	professional	76	82.61	116.78	180.31	196.6%
Aetna	93294	professional	76	29.6	35.22	47.07	124.2%
UnitedHealthcare	93017	professional	75	96.24	98.09	114.15	270.5%
UnitedHealthcare	93922	professional	74	35.94	139.41	199.96	256.8%
UnitedHealthcare	93284	professional	73	102.19	134.44	171.92	223.6%
Aetna	93320	professional	72	25.01	35.79	64.69	154.6%
Aetna	93246	professional	71	11.94	16	19.67	151.6%
Cigna	93460	professional	71	916.97	1552.7	2276.02	204.2%
UnitedHealthcare	93460	professional	70	1054.53	1802.4	2720.04	282.6%
Aetna	92960	professional	69	25.82	54.06	129.06	104.5%
Aetna	93280	professional	69	38.53	50.39	79.76	124.8%
Cigna	93283	professional	69	74.16	106.87	166.75	193.6%
Cigna	93656	professional	69	1829.18	2075.07	2649.83	276.2%
Aetna	92928	professional	68	114.56	445.16	681.6	157.7%
UnitedHealthcare	93283	professional	67	88.24	122.73	158.42	219.5%
UnitedHealthcare	93656	professional	67	2155.8	2278.37	3387.85	296.8%
Aetna	93880	professional	66	49.68	169.58	219.61	125.8%
Cigna	93227	professional	62	34.3	34.3	44.45	198.6%
Cigna	93925	professional	62	78.6	300.16	418.63	195.2%
Cigna	93970	professional	61	69.38	242.8	338.31	196.7%
Cigna	93005	professional	59	12.64	16.03	17.81	—%
UnitedHealthcare	93005	professional	59	14.92	19.45	20.57	301.7%
UnitedHealthcare	93227	professional	58	46.01	49.58	49.58	287.1%
Aetna	93242	professional	57	6.73	13.85	19.67	152.9%
Cigna	93454	professional	56	573.16	1125.57	1596.09	197.9%
UnitedHealthcare	93454	professional	56	710.33	1188.38	2083.64	276.3%
Cigna	93279	professional	53	52.7	65.85	104.11	178.8%
UnitedHealthcare	93279	professional	53	55.48	77.24	101.31	194%
UnitedHealthcare	93925	professional	53	107.04	327.24	521.87	232.7%
Aetna	93296	professional	52	22.12	26.96	37.71	91.4%
Aetna	93295	professional	51	36.66	51.32	66.69	147.6%
Cigna	93281	professional	48	69.61	86.46	137.91	194.8%
Cigna	93571	professional	48	192.04	290.48	407.39	168.3%
UnitedHealthcare	93970	professional	47	81.48	237.49	374.06	201.8%
UnitedHealthcare	93281	professional	46	70.95	103.96	138.77	213.6%
Cigna	93297	professional	46	46.25	56.59	70.44	178.9%
Cigna	93655	professional	46	556.06	787.94	975.1	324.4%
Cigna	75572	professional	45	211.32	342.58	502.68	259.2%
UnitedHealthcare	93297	professional	45	46.63	61.86	86.98	193.4%
Aetna	93298	professional	45	19.44	26.64	40.87	32.4%
Aetna	33208	professional	44	50.74	253.72	466.1	142.1%
UnitedHealthcare	93655	professional	44	718.68	833.41	1178.17	343.1%
Cigna	93350	professional	43	160.11	321.85	489.08	280.5%
Cigna	93459	professional	43	882.4	1404.03	2205.72	205.4%
UnitedHealthcare	93459	professional	43	909.94	1697.26	2665.57	282.2%
UnitedHealthcare	93571	professional	43	227.27	401.47	626.41	214.5%
Aetna	99203	professional	43	33.41	77.36	103.77	87.3%
UnitedHealthcare	75572	professional	42	197.2	343.09	502.58	252.3%
Aetna	92978	professional	42	122.13	192.12	263.93	136.9%
UnitedHealthcare	93350	professional	42	231.56	307.36	444.94	279.9%
Cigna	93971	professional	42	46.85	166.99	214.61	205.1%
Aetna	75574	professional	39	171.96	244.88	337.59	139.5%
Cigna	93272	professional	38	36.27	43.17	52.04	187.1%
Cigna	93657	professional	38	556.16	787.32	946.16	324.1%
Aetna	93460	professional	37	637.12	942.98	1360.67	137.9%
Cigna	33340	professional	36	1390.36	1396.79	2094.63	242.3%
Aetna	93005	professional	36	5.74	7.79	10.64	165.1%
Cigna	93225	professional	36	33.12	33.16	42.17	359%
UnitedHealthcare	93272	professional	36	36.31	65.06	66.39	282%
UnitedHealthcare	93282	professional	36	59.94	91.36	116.31	182.8%
Aetna	93284	professional	36	58.1	72.67	108.77	125.1%
UnitedHealthcare	93657	professional	36	719.48	810.58	1178.17	333.7%
Cigna	33361	professional	35	2148.58	2560.18	3132.76	254.9%
Cigna	93282	professional	35	60.93	79.68	133.16	178.3%
Cigna	93623	professional	35	109.69	209.3	347.29	596.1%
UnitedHealthcare	33340	professional	34	1486.2	1800.6	2109.9	312.4%
Cigna	93978	professional	34	81.38	257.24	328.07	199.1%
UnitedHealthcare	93225	professional	33	47.74	47.74	50.72	285.4%
Cigna	93288	professional	33	30.62	45.98	65.25	158.3%
Aetna	93922	professional	33	18.29	67.08	102.82	134.2%
UnitedHealthcare	93978	professional	33	103	329.62	439.11	260.4%
UnitedHealthcare	93288	professional	32	28.96	49.82	74.33	144.8%
UnitedHealthcare	93623	professional	32	283	447.04	694.18	622.7%
Cigna	93653	professional	32	1347.3	1545.32	1904.45	233.2%
UnitedHealthcare	93971	professional	32	60.1	145.44	269.36	218.7%
Cigna	33249	professional	31	1574.47	1631.52	1836.69	219.5%
UnitedHealthcare	33249	professional	31	1722.39	2025.53	2337.18	269.5%
Aetna	93227	professional	31	9.14	18.28	24.29	138.3%
Aetna	93283	professional	31	54.29	66.28	98.38	122.9%
Aetna	93925	professional	31	47.14	198	241.1	117.2%
Aetna	93970	professional	31	42.05	173.86	212.03	126.9%
UnitedHealthcare	33361	professional	30	2741.28	2874.99	3389.01	286.3%
Cigna	75561	professional	30	309.54	598.65	795.18	248.5%
Aetna	93017	professional	30	28.16	35.98	58.66	173.7%
UnitedHealthcare	93653	professional	30	1455.01	1937.35	2366.76	289.8%
UnitedHealthcare	75561	professional	29	367.75	582.69	841.49	288.9%
Aetna	93351	professional	29	145.65	218.35	271.45	144.3%
Aetna	93656	professional	28	163.09	543.64	1087.27	144.7%
Cigna	33225	professional	27	807.07	866.08	994.49	235.7%
UnitedHealthcare	33225	professional	27	884.51	1084.97	1775.79	295.3%
Aetna	93297	professional	27	15.12	25.87	40.04	54.4%
Aetna	93454	professional	27	418.29	802.75	1080.1	133.6%
Cigna	99212	professional	27	37.47	47.9	60.91	84.9%
UnitedHealthcare	99212	professional	27	40.5	49.87	75.71	88.3%
Cigna	33228	professional	25	601.89	635.04	708.44	216.3%
Aetna	93288	professional	25	26.78	35.93	56.52	109.1%
UnitedHealthcare	33228	professional	24	605.33	839.48	862.71	285.9%
Aetna	75572	professional	24	147.56	253.15	324.87	182.1%
Cigna	93307	professional	23	83.75	168.67	252.42	193.8%
UnitedHealthcare	93307	professional	23	93.98	189.27	247.34	214.3%
Cigna	75565	professional	22	30.47	82.43	104.61	259.3%

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