What do payers pay cardiology groups in TN?

Across 520 NPIs, the median published rate is 112.7% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 69 procedure codes and 3 payers, the median published rate is 181 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 207 percent and Aetna the lowest at 145 percent, a spread of 62 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 520 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 TN?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
Cigna	99214	professional	520	123.49	143.48	159.26	112.7%
UnitedHealthcare	99214	professional	517	117.63	156.91	175.72	123.2%
Aetna	99214	professional	511	40	89.22	120.9	82.2%
Cigna	93000	professional	430	24.67	28.63	38.01	201.1%
Cigna	99204	professional	428	187.63	223.33	253.19	134.4%
UnitedHealthcare	93000	professional	427	27	31.68	33.06	222.6%
UnitedHealthcare	99204	professional	426	192.04	250.01	273.9	150.5%
Aetna	93000	professional	424	6.74	14.83	23.35	158.1%
Aetna	99204	professional	421	40	126.53	185.86	93.7%
Cigna	93306	professional	403	145.27	230.33	327.11	196.3%
UnitedHealthcare	93306	professional	400	156.88	234.7	347.72	210.6%
Aetna	93306	professional	398	114.55	174.62	229.63	149.1%
Cigna	93010	professional	326	13.36	14.82	22	185.6%
UnitedHealthcare	93010	professional	325	12.41	16.48	18.34	206.4%
Aetna	93010	professional	319	3.91	7.81	12.59	145.2%
UnitedHealthcare	93018	professional	307	23.5	28.76	32.84	217.8%
Cigna	93018	professional	306	22.77	25.86	31.43	195.8%
Aetna	93018	professional	302	6.89	14.7	22.2	159%
Cigna	78452	professional	298	152.28	472.29	648.99	166.3%
UnitedHealthcare	78452	professional	296	136.21	461.4	576.34	144%
Aetna	78452	professional	294	113.81	381.44	532.44	133.8%
Cigna	99213	professional	281	82.91	95.96	104.52	107.4%
UnitedHealthcare	99213	professional	279	81.91	105.8	121.9	118.4%
Aetna	99213	professional	277	30.04	57.82	77.73	80.2%
UnitedHealthcare	93016	professional	272	33.5	41.89	49.12	209.1%
Cigna	93016	professional	270	33.83	38.11	46.31	190.2%
Aetna	93016	professional	265	10.3	22.71	34.62	157%
Cigna	99215	professional	247	178.79	197.67	220.94	109.3%
UnitedHealthcare	99215	professional	241	165.23	219.89	253.28	121.6%
Aetna	99215	professional	236	40	119.26	162.75	82.6%
Cigna	93458	professional	234	606.69	1163.48	1614.97	189.7%
Aetna	93458	professional	232	515.13	962.5	1270.5	158.1%
UnitedHealthcare	93458	professional	232	649.73	1229.95	1724.06	207.1%
Cigna	93308	professional	214	55	124.84	167.5	190.5%
Aetna	93308	professional	212	40	63.35	106.85	144%
UnitedHealthcare	93308	professional	210	57.73	116.46	165.45	189.6%
Cigna	93325	professional	208	8.44	36.83	50.75	198.9%
UnitedHealthcare	93325	professional	207	7.24	37.1	48.19	210.5%
Aetna	93325	professional	206	5.35	21.51	34.37	160.1%
UnitedHealthcare	93312	professional	170	214.33	279.59	375.49	210.4%
Cigna	93312	professional	169	190.48	271.55	395.57	196.5%
UnitedHealthcare	92960	professional	168	216.63	291.05	298.09	198.1%
Aetna	93312	professional	168	55.19	146.65	223.34	147.4%
Cigna	92960	professional	167	223.26	236.69	333.45	161.7%
Aetna	92960	professional	160	25.62	63.35	136.97	111.4%
Cigna	93228	professional	159	40.7	47.66	74.02	200%
UnitedHealthcare	93228	professional	156	41.23	51.01	60.15	214.1%
Aetna	93228	professional	153	26.71	32.33	46.55	115%
Cigna	99205	professional	144	243.83	269.47	323.47	121.7%
Cigna	93248	professional	142	42.64	43.7	49.32	183.1%
Cigna	93320	professional	141	38.75	59.31	84.43	193.3%
UnitedHealthcare	93320	professional	141	40.82	60.58	92.85	207.4%
UnitedHealthcare	93248	professional	140	43.13	52.56	61.63	220.3%
Cigna	93294	professional	140	50.69	56.86	66.19	203%
Aetna	93248	professional	139	16.82	30.27	44.57	179.8%
UnitedHealthcare	93294	professional	139	43.69	59.79	63.13	213.4%
Aetna	93320	professional	139	24.36	34.81	57.72	139.8%
Aetna	99205	professional	139	48	171.1	254.87	90.7%
UnitedHealthcare	99205	professional	139	228.45	310.58	366.43	140.3%
Aetna	93294	professional	136	33.71	44.01	49.53	157.1%
Cigna	93280	professional	132	59.31	78.1	116.8	165.6%
UnitedHealthcare	93280	professional	132	57.61	75.91	112.24	178.8%
Aetna	92928	professional	131	106.34	348.59	626.66	166.7%
Cigna	92928	professional	130	900.56	1038.14	1202.37	245.6%
UnitedHealthcare	92928	professional	130	923.39	1109.11	1288.33	262.3%
Aetna	93280	professional	130	37.32	54.69	72.3	129.6%
Cigna	93321	professional	126	19.22	33.03	51.86	201.1%
UnitedHealthcare	93321	professional	125	17.09	34.51	48.76	233.9%
Aetna	93321	professional	124	10.99	17.39	33.38	167.1%
Cigna	93244	professional	121	39.73	43.38	45.18	198.2%
UnitedHealthcare	93244	professional	121	39.25	47.85	56.11	218.6%
Aetna	93244	professional	116	21.67	28.32	40.36	178.3%
Cigna	93296	professional	103	35.42	40.99	50.89	142.7%
UnitedHealthcare	93296	professional	102	36.11	45.59	46.9	158.7%
Aetna	93296	professional	99	26.58	36.62	42.37	127.5%
Cigna	93298	professional	99	46.49	78.25	135.59	174.3%
UnitedHealthcare	93298	professional	98	44.4	56.1	165.74	119.4%
Cigna	93295	professional	97	69.49	82.89	110.53	241.3%
UnitedHealthcare	93295	professional	97	71.78	75.58	84.34	220%
Aetna	93295	professional	96	39.88	58.9	67.05	171.5%
Aetna	93298	professional	95	10.56	20.98	31.73	30.8%
Cigna	93015	professional	83	110.56	126.94	155.34	185.3%
Aetna	93015	professional	82	20.41	46.23	96.45	152.1%
Cigna	93880	professional	82	76.52	207.28	312.12	174.2%
Aetna	93880	professional	81	48.83	141.36	216.43	137.1%
UnitedHealthcare	93880	professional	81	79.45	234.08	322.75	190.8%
UnitedHealthcare	93015	professional	79	89.55	128.74	151.61	187.9%
Aetna	33208	professional	72	75.19	316.77	622.64	186.1%
Cigna	33208	professional	72	803.49	876.15	1117.4	210.9%
UnitedHealthcare	33208	professional	72	822.3	1091.48	1162.38	262.7%
Aetna	99203	professional	71	36.94	84.07	126.4	96.3%
Cigna	99203	professional	71	116.45	128.14	142.49	116.8%
UnitedHealthcare	99203	professional	70	117.14	150.43	159.38	137.1%
Cigna	93246	professional	69	18.21	21.16	23.3	214.3%
UnitedHealthcare	93246	professional	68	19.96	25.25	32.53	240.4%
Aetna	93246	professional	67	9.05	14.64	25.49	212.4%
Cigna	93356	professional	67	36.2	39.38	44.68	116.3%
UnitedHealthcare	93356	professional	67	39.26	46.94	55.01	138.7%
Cigna	93242	professional	65	18.21	20.56	23.3	200.5%
UnitedHealthcare	93242	professional	65	19.37	23.63	28.48	225%
Aetna	93284	professional	65	58.43	90.75	112.83	122.7%
Cigna	93284	professional	65	82.85	120.64	172.97	183.2%
UnitedHealthcare	93284	professional	65	68.62	121.92	169.53	191.2%
Aetna	93356	professional	65	11.98	23.95	35.68	94.7%
Aetna	93460	professional	64	654.08	1031.32	1491.65	155.1%
Cigna	93460	professional	63	763.28	1422.29	1969.59	191.4%
UnitedHealthcare	93460	professional	63	823.45	1459.26	2034.45	208.6%
Aetna	92978	professional	61	117.2	166.06	257.4	133.5%
Cigna	92978	professional	61	204.39	287.18	433.36	197.6%
UnitedHealthcare	92978	professional	61	208.89	343.77	565.85	240.3%
Aetna	93242	professional	59	13.56	14.64	25.49	171.4%
Aetna	93656	professional	59	210.9	827.06	1309.19	181.5%
Cigna	93656	professional	58	1675.26	1883.13	2730.86	256.2%
UnitedHealthcare	93656	professional	58	1924.34	2376.08	2606.05	323.3%
Cigna	93283	professional	57	78.73	119.38	165.57	188%
UnitedHealthcare	93283	professional	57	70.88	113.9	156	195.9%
Aetna	93297	professional	57	14.13	18.9	27.62	53.2%
Cigna	93297	professional	57	43.01	54.11	67.92	174.3%
UnitedHealthcare	93297	professional	57	43.35	54.43	74.79	96.4%
Aetna	93459	professional	55	584.19	920.32	1304.45	133.1%
Cigna	93227	professional	54	36.73	46.5	55.9	271.6%
Aetna	93227	professional	53	5.09	10.64	19.58	114.4%
UnitedHealthcare	93227	professional	53	43.77	52.28	55.19	305.3%
Cigna	93459	professional	53	856.57	1225.58	1870.17	190.2%
UnitedHealthcare	93459	professional	53	747.72	1327.42	1870.11	241.5%
Cigna	93288	professional	52	36.56	51.36	74.79	161.8%
UnitedHealthcare	93288	professional	52	28.6	42.26	62.06	140.4%
Aetna	93454	professional	51	410.33	776.15	1085.63	154.6%
Aetna	93288	professional	50	29.8	37.66	55.22	114.3%
Aetna	93283	professional	49	53.53	86.71	103.73	138.3%
Cigna	93454	professional	49	683.7	1107.37	1573.38	196.7%
UnitedHealthcare	93454	professional	49	526.68	1113.19	1625.2	208.6%
Cigna	93793	professional	46	12.75	18.34	24.22	166%
Aetna	93793	professional	44	2.49	11.66	16.32	128.4%
UnitedHealthcare	93793	professional	44	18.35	22.36	22.36	202.4%
Aetna	33340	professional	43	197.07	799.95	1197.03	209.2%
Cigna	33340	professional	43	1227.58	1329.64	1632.18	236%
UnitedHealthcare	33340	professional	43	1175.85	1656.42	1742.89	294%
Cigna	75574	professional	43	228.86	428.88	629.34	201.2%
Cigna	93279	professional	43	53.84	77.06	103.71	183.4%
UnitedHealthcare	93279	professional	43	53.6	67.14	97.82	187.5%
Aetna	75574	professional	42	142.26	246.63	331.29	117.1%
UnitedHealthcare	75574	professional	41	207.46	339.95	469.24	157.3%
Aetna	93571	professional	41	92.54	129.43	202.38	113.1%
Cigna	93571	professional	41	156.75	259.87	368.38	169.5%
UnitedHealthcare	93571	professional	41	158.67	266.06	417.62	177.7%
Cigna	93655	professional	41	555.67	657.71	883.84	276.8%
UnitedHealthcare	93655	professional	41	683.07	909.83	940.84	382.9%
Aetna	93655	professional	40	76.86	288.23	457.02	212.1%
Aetna	93272	professional	38	11.81	28.06	40.63	157.7%
Cigna	93272	professional	38	44.75	47.06	54.42	205.9%
UnitedHealthcare	93272	professional	38	41.36	49.27	68.55	215.5%
Cigna	93281	professional	35	69.77	99.95	131.97	193.2%
UnitedHealthcare	93281	professional	35	76.31	92.2	140.05	196.1%
Cigna	93657	professional	34	577.31	656.95	883.84	276.5%
UnitedHealthcare	93657	professional	34	683.83	909.09	941.67	382.6%
Aetna	93279	professional	33	32.6	53.28	62	157.7%
Aetna	93925	professional	33	56.3	179.91	252.33	124.7%
Cigna	93925	professional	33	61.82	231.85	360.24	149.7%
UnitedHealthcare	93925	professional	32	76.23	276.79	407.31	188.5%
Aetna	93657	professional	31	76.8	288.41	502.95	219.1%
Aetna	93970	professional	30	52.4	138.85	232.61	160%
Cigna	93970	professional	30	54.3	179.85	280.17	162.3%
Cigna	78492	professional	29	153.68	531.14	646.66	139.8%
Aetna	93351	professional	29	116.34	163.84	240.06	119.4%
Cigna	93351	professional	29	159.09	241.08	355.93	177.1%
UnitedHealthcare	78492	professional	28	122.82	1374.93	1552.93	152.4%
UnitedHealthcare	93351	professional	28	163.85	242.53	331.85	180.4%
UnitedHealthcare	93970	professional	28	66.2	188.46	298.31	154%
Aetna	33228	professional	27	75.8	273.94	394.58	127.2%
Cigna	33249	professional	27	1394.61	1495.7	2067.89	205.8%
UnitedHealthcare	33249	professional	27	1439.03	1920.86	2085.61	264.2%
Aetna	78492	professional	27	300	590.62	1293.75	541.8%
Aetna	93281	professional	27	40.41	67.05	77.58	133.1%
Aetna	93282	professional	27	44.2	64.11	80.68	135.4%
Cigna	93282	professional	27	65.89	95.37	124.11	183.3%
UnitedHealthcare	93282	professional	27	57.64	85.48	114.86	189.7%
Cigna	33361	professional	26	2051.86	2203.05	3276.56	224.3%
UnitedHealthcare	33361	professional	26	2321.6	2584.15	2782.42	263.1%
Cigna	33228	professional	25	538.64	594.62	756.48	207.1%
UnitedHealthcare	33228	professional	25	477.86	627.65	797.09	218.6%
Aetna	93289	professional	25	34.52	41.42	65.84	109.3%
Cigna	93289	professional	25	53.33	72.54	106.5	171.2%
UnitedHealthcare	93289	professional	25	44.67	63.54	79	150.9%
Aetna	93653	professional	24	150.99	566.21	1016.27	158.8%
Cigna	93971	professional	24	38.02	109.71	188.64	163.1%
Cigna	33225	professional	23	714.2	786.21	1065.83	218.7%
UnitedHealthcare	33225	professional	23	793.04	1002.93	1060.86	279%
Aetna	33249	professional	23	88.37	640.65	1351.5	188.6%
Cigna	93350	professional	23	208.04	240.09	345.7	237.2%
UnitedHealthcare	93350	professional	23	195.13	256.26	401.16	298.2%
Cigna	93653	professional	23	1287.49	1429.27	1900.42	220.5%
UnitedHealthcare	93653	professional	23	1321.3	1785.12	1919.2	275.4%
Aetna	93971	professional	23	34.14	87.29	146.23	160.1%
Aetna	33361	professional	22	194.67	603.08	1184.79	181.4%
Cigna	93922	professional	22	21.51	90.21	141.49	178.8%
UnitedHealthcare	93922	professional	22	24.04	115.33	148.13	193.8%
Cigna	93923	professional	22	42.63	165.57	208.99	182%
Cigna	99212	professional	22	44.41	52	65.25	93.8%
UnitedHealthcare	99212	professional	22	46	60.76	75.14	109.6%

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