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Rate benchmarks

What do payers really pay?

Every major insurer is federally required to publish its negotiated rates in machine-readable files. We normalize those disclosures — refreshed monthly — into clean, national benchmarks with an office/facility split, so you can see the median, the range, and the percent of Medicare for a code at a glance.

Aetna

  • CPT 99203 — New patient office visit, level 3
  • CPT 99204 — New patient office visit, level 4
  • CPT 99213 — Established patient office visit, level 3
  • CPT 99214 — Established patient office visit, level 4
All Aetna benchmarks →

Cigna

  • CPT 99203 — New patient office visit, level 3
  • CPT 99204 — New patient office visit, level 4
  • CPT 99213 — Established patient office visit, level 3
  • CPT 99214 — Established patient office visit, level 4
All Cigna benchmarks →

UnitedHealthcare

  • CPT 99203 — New patient office visit, level 3
  • CPT 99204 — New patient office visit, level 4
  • CPT 99213 — Established patient office visit, level 3
  • CPT 99214 — Established patient office visit, level 4
All UnitedHealthcare benchmarks →

BlueCross BlueShield of Tennessee

  • CPT 99203 — New patient office visit, level 3
  • CPT 99204 — New patient office visit, level 4
  • CPT 99213 — Established patient office visit, level 3
  • CPT 99214 — Established patient office visit, level 4
All BlueCross BlueShield of Tennessee benchmarks →

Rates by state

National medians can over- or under-state a local market. State-scoped benchmarks — Tennessee first — compute the same medians over in-state contracting groups only.

  • Aetna in Tennessee
  • Cigna in Tennessee
  • UnitedHealthcare in Tennessee
  • BlueCross BlueShield of Tennessee in Tennessee

Rates by specialty

  • Anesthesiology
  • Interventional Spine
  • Ophthalmology
  • Hospital Medicine
  • Urgent Care
  • Primary Care
  • Pediatrics

See where your own contracts stand

These pages show the market. EarnestMD resolves your providers and benchmarks your actual rates against comparable practices — then builds the case for the increase.

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Source: payer Transparency in Coverage machine-readable files. Aggregate benchmarks only; no individual practice or contract is identified. EarnestMD is independent and not affiliated with any insurer.

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Payer rate intelligence for provider contract negotiations. Built from public federal price-transparency filings.

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Rate figures are derived from payers’ public price-transparency filings published under the Transparency in Coverage rule. EarnestMD is independent and not affiliated with any insurer.