What do payers pay cardiology groups in TX?

Across 1838 NPIs, the median published rate is 91.7% of locality-adjusted Medicare (September 2026 files).

Data as of the September 2026 payer files.

Across 71 procedure codes and 3 payers, the median published rate is 137 percent of locality-adjusted Medicare in the September 2026 payer files. UnitedHealthcare publishes the highest median at 169 percent and Aetna the lowest at 116 percent, a spread of 53 points on identical work. 3 of 3 payers sit at or above Medicare. The best-covered row rests on 1838 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 TX?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
UnitedHealthcare	99214	professional	1838	100.35	128.34	149.98	91.7%
Cigna	99214	professional	1827	118.6	133.24	165.59	98.6%
Aetna	99214	professional	1713	44.28	96.83	132.35	81.6%
Cigna	93306	professional	1609	120.46	194.85	271.37	148.9%
UnitedHealthcare	93306	professional	1609	137	205.99	308.97	172.2%
UnitedHealthcare	93000	professional	1580	23.38	27.72	37.13	198.5%
Cigna	93000	professional	1571	18.75	22.86	30.5	148.9%
UnitedHealthcare	99204	professional	1520	159.06	185.8	224.36	109.7%
Cigna	99204	professional	1509	165.08	195.74	227.96	110.1%
Aetna	93306	professional	1485	86.81	147.14	227.66	119.8%
Aetna	93000	professional	1475	7.12	15.1	19.98	108.5%
Aetna	99204	professional	1408	45.35	135.78	182.92	88.2%
UnitedHealthcare	99213	professional	1149	73.16	82.91	105.54	86.6%
Cigna	99213	professional	1139	80.62	89.25	111.42	94.5%
Aetna	99213	professional	1078	42	67.99	91.3	80.6%
Cigna	78452	professional	1031	107.89	365.27	499.09	111.1%
UnitedHealthcare	78452	professional	1029	134.48	467.03	626.13	146.3%
UnitedHealthcare	93010	professional	1013	11.46	14.93	18.74	185.6%
Cigna	93010	professional	1007	10.73	12.32	15.84	150%
Aetna	78452	professional	961	100.74	319.94	470.6	108.1%
Aetna	93010	professional	912	4.14	8.77	10.92	117%
Cigna	99215	professional	852	173.55	194.34	238.11	103%
UnitedHealthcare	99215	professional	851	141.63	179.89	238.83	94.7%
UnitedHealthcare	93015	professional	796	97.48	115.08	131.73	158%
Cigna	93015	professional	793	90.78	94.7	135.72	132%
Aetna	99215	professional	768	45.35	134.3	206.96	81.5%
UnitedHealthcare	93458	professional	751	609.9	1051.21	1473.17	165.1%
Cigna	93458	professional	739	549.37	1054.12	1435.38	152.1%
Aetna	93015	professional	734	28.23	71.94	96.05	116%
Cigna	93880	professional	708	52.61	195.63	265.41	136.2%
UnitedHealthcare	93880	professional	707	68.18	213.73	284.34	157%
Aetna	93458	professional	701	402.79	794.44	1107.96	117.6%
Aetna	93880	professional	663	45.68	160.2	203.65	116%
UnitedHealthcare	93018	professional	661	18.56	24.08	30.25	183.7%
Cigna	93018	professional	658	18.83	22.58	27.91	166.9%
Aetna	93018	professional	637	7.04	14.83	17.15	119.6%
Cigna	93325	professional	609	7.09	30.36	46.28	183.9%
UnitedHealthcare	93325	professional	609	6.43	35.27	44.38	190.9%
Aetna	93325	professional	547	4.43	21.74	29.47	123.5%
Cigna	93294	professional	544	37.61	43.49	55.83	151.8%
UnitedHealthcare	93294	professional	542	40.63	47.99	56.43	164.9%
UnitedHealthcare	93308	professional	539	49.92	123.12	171.66	180%
Cigna	93308	professional	536	50.12	120.21	153.71	172.9%
Cigna	93312	professional	498	176.13	269.98	363.39	185.9%
UnitedHealthcare	93312	professional	497	197.84	252.63	382.28	190.4%
Aetna	93294	professional	493	29.29	33.77	39.58	115%
Cigna	93280	professional	485	46.68	62.72	93.39	130.2%
UnitedHealthcare	93016	professional	484	27.76	36.01	42.48	178.1%
UnitedHealthcare	93280	professional	482	44.76	61.25	78.78	126.3%
Cigna	93016	professional	478	28.51	33.95	41.82	166.5%
Aetna	93308	professional	471	39.43	69.98	106.59	119.3%
Cigna	93228	professional	466	31.45	34.68	43.07	137.6%
UnitedHealthcare	93228	professional	465	28.8	37.14	48.19	151.4%
Cigna	93356	professional	461	32.93	35.44	50.52	100.6%
Aetna	93312	professional	458	79.21	139.97	225.21	118.7%
UnitedHealthcare	99205	professional	456	215.21	271.19	350.01	116.8%
Cigna	99205	professional	453	230.74	265.93	329.82	114.6%
Aetna	93016	professional	452	11.81	22.27	26.03	120%
UnitedHealthcare	93356	professional	450	33.43	46.22	49.44	127.1%
Aetna	93280	professional	435	37.24	49.15	69.53	116%
Aetna	93228	professional	433	26.73	29.64	36.26	113.7%
UnitedHealthcare	92928	professional	419	745.93	963.62	1221.22	221.7%
Aetna	93356	professional	412	12.79	23.23	28.77	70.1%
Cigna	92928	professional	408	747	897.88	1110.74	198%
Aetna	99205	professional	406	47.52	186.61	309.34	86.1%
UnitedHealthcare	93970	professional	394	63.92	202.9	268.21	154.7%
Cigna	93970	professional	391	48.47	189.75	253.54	137.6%
Cigna	93320	professional	388	34.64	51.88	74.29	166.5%
UnitedHealthcare	93320	professional	387	34.47	60.26	81.83	187.7%
UnitedHealthcare	93925	professional	385	67.43	267	348.6	152.5%
Cigna	93925	professional	384	52.03	246.49	332.9	136%
Aetna	92928	professional	379	107.29	465.77	645.99	137.7%
Cigna	93296	professional	379	29.26	34.02	47.77	111.1%
Aetna	93970	professional	379	39.74	157.16	205.5	117.4%
UnitedHealthcare	93296	professional	378	36.28	44.95	51.84	142.7%
Aetna	93925	professional	367	45.3	196.98	263.6	115.9%
Cigna	93248	professional	361	37.35	44.02	53.6	179.6%
UnitedHealthcare	93248	professional	358	42.81	52	56.29	210.1%
Aetna	93320	professional	351	22.4	37.88	59.34	129.3%
UnitedHealthcare	92960	professional	330	198.94	244.39	274.73	163%
Aetna	93296	professional	330	24.32	30.2	36.55	95.5%
Cigna	93244	professional	326	32.97	39.06	48.73	173%
Cigna	92960	professional	324	178.61	241.23	266.14	158.8%
UnitedHealthcare	93244	professional	324	35.71	45.46	48.9	198.8%
UnitedHealthcare	99203	professional	313	109.35	134.76	160	113.2%
UnitedHealthcare	93321	professional	309	15.13	33.96	45.65	195.2%
Cigna	93321	professional	306	15.23	32.13	45.67	188.9%
Cigna	99203	professional	306	110.58	126.41	149.7	108.4%
Cigna	93298	professional	298	37.51	57.36	104.21	129.6%
Aetna	93248	professional	296	13.15	27.63	31.9	123.1%
UnitedHealthcare	93298	professional	296	34.44	42.35	52.05	42.9%
Cigna	93295	professional	295	48.72	74.19	106.95	206%
UnitedHealthcare	93295	professional	294	62.52	72.83	78.61	202.7%
Aetna	92960	professional	286	42	72.9	138.17	95.1%
Aetna	99203	professional	283	42	92.33	123.48	85.4%
Aetna	93244	professional	279	14.34	25.13	29	121.6%
Aetna	93298	professional	272	17.7	28.62	61.35	47.2%
Aetna	93321	professional	263	9.63	21.28	30.58	120.3%
Aetna	93295	professional	261	36.17	41.84	50.34	117.7%
Cigna	93246	professional	228	13.31	20.5	28.95	210.6%
UnitedHealthcare	93246	professional	227	24.33	28.53	29.82	255.6%
UnitedHealthcare	93229	professional	215	551.54	747.22	852.04	99.5%
Cigna	93297	professional	214	35.64	45.98	53.36	128%
UnitedHealthcare	93297	professional	214	30.14	41.13	55.45	71%
Aetna	93229	professional	213	736.45	835.11	897.38	113.3%
UnitedHealthcare	33208	professional	211	672.33	891.44	1208	193.8%
Cigna	93242	professional	209	8.25	19.46	28.84	210.6%
UnitedHealthcare	93242	professional	208	22.24	28.53	29.82	247.2%
Cigna	93229	professional	205	906.41	998.18	1059.75	134.7%
Cigna	33208	professional	204	680.48	825.65	951.31	183%
UnitedHealthcare	92978	professional	199	183.76	311.62	437.67	182%
Cigna	93284	professional	194	61.08	98.65	138.46	138.3%
Cigna	92978	professional	193	181.61	280.26	400.62	163.2%
UnitedHealthcare	93971	professional	193	47.89	135.58	178.94	160.7%
UnitedHealthcare	93284	professional	192	63.06	95.95	132.55	146.9%
Cigna	93971	professional	192	35.4	128.77	164.56	140.2%
UnitedHealthcare	93351	professional	191	172.43	277.27	361.19	196.1%
Cigna	93351	professional	190	167.42	256.2	339.67	171%
UnitedHealthcare	93288	professional	186	26.79	39.59	53.37	122.9%
Aetna	93297	professional	186	15.58	27.68	45.88	79.8%
Cigna	93288	professional	185	28.79	40.59	63.11	126.7%
Aetna	93971	professional	183	24.82	99.51	126.65	116%
Aetna	33208	professional	182	68.17	358.6	590.39	141.7%
Aetna	93246	professional	180	8.01	15.1	16.29	133.1%
UnitedHealthcare	93656	professional	180	1648.5	2061.14	2604.41	257.5%
Aetna	92978	professional	174	106.53	155.14	224.53	117.8%
Cigna	93922	professional	174	19.47	87.4	119.03	135.9%
UnitedHealthcare	93922	professional	173	30	92.34	129.16	154.4%
Cigna	93656	professional	172	1489.62	1734.39	2080.96	210.1%
Aetna	93242	professional	171	7.8	13.41	16.13	131.1%
Aetna	93288	professional	164	26	38.43	56.88	111.2%
Aetna	93656	professional	161	209.8	905.88	1271.97	147.7%
Aetna	93922	professional	161	15.15	70.31	92.88	113.4%
Aetna	93284	professional	160	55.95	71.49	110.78	117.6%
Cigna	93283	professional	159	59.62	92.37	126.15	142.2%
UnitedHealthcare	93283	professional	156	59.6	90.41	128.69	147.8%
Aetna	93351	professional	154	106.51	183.96	268.18	124.8%
UnitedHealthcare	93460	professional	145	781.34	1388.06	1983.37	182.9%
UnitedHealthcare	33340	professional	141	1070.44	1330.9	1510.24	215.8%
Cigna	33340	professional	139	1074.14	1272.69	1595.63	205.4%
UnitedHealthcare	93454	professional	139	467.24	972.54	1324.81	172.3%
Cigna	93460	professional	136	717.08	1313.38	1837.49	168.8%
Cigna	99457	professional	136	41.1	44.13	50.96	85.7%
UnitedHealthcare	99457	professional	134	42.39	46.55	51.9	92.2%
Aetna	93283	professional	133	51.46	66.06	104.33	117.8%
Aetna	93460	professional	133	509.35	984.51	1404.34	118.8%
UnitedHealthcare	93241	professional	130	81.77	91	104.39	33.3%
UnitedHealthcare	93459	professional	130	654.01	1217.46	1629.94	174.9%
Cigna	93454	professional	129	446.22	976.12	1297.31	166.1%
Aetna	99457	professional	129	16.7	33.38	38.44	73.6%
Cigna	78492	professional	128	133.67	436.88	678.28	130.7%
UnitedHealthcare	78492	professional	127	162.02	1344.78	2452.88	175.1%
Cigna	99454	professional	126	51.53	59.26	69.91	117.4%
Aetna	93241	professional	125	57.71	136.59	293.22	85.7%
UnitedHealthcare	99454	professional	124	65.56	71.82	77.55	142.8%
Cigna	93459	professional	123	640.57	1164.83	1642.59	164.6%
Aetna	99454	professional	120	22.92	45.71	57.14	105%
Aetna	93454	professional	119	348.71	701.32	1046.09	118.8%
Cigna	93793	professional	119	15.48	22.64	22.64	193.9%
UnitedHealthcare	93793	professional	116	17.25	21.74	21.74	186.2%
Aetna	78492	professional	115	120	500	1080	150.3%
Aetna	33340	professional	110	205.73	781.95	944.67	149.1%
Cigna	99212	professional	110	45.8	51.94	63.94	87.7%
UnitedHealthcare	93657	professional	109	603.49	724.66	882.06	277.4%
UnitedHealthcare	99212	professional	109	38.72	50	53.79	83.1%
Cigna	93657	professional	108	531.62	611.24	773.14	236.2%
UnitedHealthcare	93655	professional	107	603.75	743.75	855	286.5%
Cigna	93655	professional	106	554.42	612.99	729.72	240.6%
UnitedHealthcare	93224	professional	105	105.44	128.45	143.63	184.2%
Cigna	93241	professional	105	205.5	227.7	325.9	82.1%
Aetna	93459	professional	104	424.5	809.47	1171.41	116.5%
Cigna	93224	professional	103	88.24	99.94	128.93	141.6%
Aetna	99212	professional	103	39.93	42.82	50.9	74.4%
Cigna	99490	professional	102	41.7	49.5	59.36	76.2%
Aetna	93224	professional	101	30.14	66.75	85.18	110.8%
UnitedHealthcare	99490	professional	101	39.41	42.91	46.13	66.7%
Cigna	93279	professional	100	42.4	63.34	84.72	146.4%
Aetna	99490	professional	100	43.65	46.67	55.87	78.3%
UnitedHealthcare	93279	professional	98	48.1	58.34	79.28	156.5%
UnitedHealthcare	93623	professional	98	216.06	295.83	472.77	505.2%
Cigna	93623	professional	97	87.25	183.98	291.24	421.5%
Cigna	93978	professional	97	53.48	172.41	255.26	129.5%
UnitedHealthcare	93978	professional	97	70.46	192.76	278.74	158.6%
Cigna	99458	professional	97	36.87	39.82	46.64	96.6%
UnitedHealthcare	99458	professional	96	36.3	42.6	46.61	103.9%
Cigna	75574	professional	94	202.84	329.87	542.89	165.7%
UnitedHealthcare	33361	professional	93	1741.34	2143.19	2341.83	196.3%
UnitedHealthcare	75574	professional	93	220.64	368.01	541.32	183.5%
UnitedHealthcare	93005	professional	93	14.5	15.8	15.8	229.7%
UnitedHealthcare	93653	professional	93	1185.18	1498.55	1939.35	200.3%
Cigna	93005	professional	92	7.15	11.92	12.22	407.1%
UnitedHealthcare	93227	professional	92	38.71	47.56	53.59	272.8%
Cigna	99453	professional	92	20.07	20.95	23.05	101.6%
Cigna	33361	professional	91	1622.29	2025.87	2522.17	191.5%
Cigna	93227	professional	91	30.72	37.23	51.46	209.7%
Cigna	93281	professional	91	55.07	84.25	109.92	156.5%
Aetna	93655	professional	91	53.02	245.84	354.1	135%
Aetna	93657	professional	91	59.53	290.44	356.85	134.8%
UnitedHealthcare	99453	professional	91	19.63	21.41	23.07	104.1%
Aetna	99458	professional	91	14.77	31.69	34.59	81.8%

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