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Payer contract guide

Official sources linked below

Negotiating with Cigna: Fee Schedule and Reimbursement Rate Benchmarks for 2026

Cigna Healthcare's current U.S. business centers on employer-sponsored plans, with medical, pharmacy, behavioral, dental, and supplemental benefits. Cigna also has an international health business. PayerPrice structures the published Cigna rate records it tracks so contract teams can compare the same plan, market, and provider type.

CIG

Cigna Healthcare

U.S. employer-sponsored and international health benefits

Plans tracked

Providers (NPIs)

Rate observations

MRF publication cadence

Monthly

Last refresh

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Cigna Overview

Cigna Healthcare, at a glance

Cigna Healthcare's current U.S. business centers on employer-sponsored plans, with medical, pharmacy, behavioral, dental, and supplemental benefits. Cigna also has an international health business.

Use the network and product named in the provider agreement when comparing rates. Cigna-branded plans do not necessarily share one schedule.

Payer sources

The Cigna Group: Cigna Healthcare

Cigna reimbursement can vary by product, network, provider contract, service details, and geographic location. Match those attributes before relying on a parent-brand benchmark.

Quick Facts

OFFICIAL PAYER + PAYERPRICE DATA

Payer TypeNational commercial payer
Total Membership
Market Share
Plan Types
U.S. Employer
International Health
Plans Tracked in PayerPrice
Data SourceMachine Readable Files (TiC Rule)
Data FreshnessUpdated monthly

Negotiation Playbook

How to negotiate better Cigna reimbursement rates

Use these four steps to check the current contract, choose comparable rates, and prepare a specific proposal for Cigna.

Step 1

Benchmark your current rates

Start with the executed contract and recent remittances. Confirm which rates are in use before comparing them with published data.

Step 2

Prioritize material services

Use paid claims to find the services that matter most financially. The priority list should reflect your practice, not an arbitrary number of codes.

Step 3

Build a comparable peer set

Compare published rates from the same plan and market for similar providers. Use them as context; they do not prove what another provider was paid on a specific claim.

Step 4

Build the negotiation case

Show the current terms, matched benchmarks, expected financial effect, and proposed rates. Spell out any assumptions.

Build a proposal the payer can evaluate.

Match published rates to the contract's network and market, then apply your own service mix to estimate the financial effect.

See our full payer contract negotiations guide for the deep dive.

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Reimbursement Rates · National Avg.

Cigna rates for commonly billed CPT codes

These national-average in-network rates come from the latest available PayerPrice dataset. The table also shows the Medicare allowed amount for each selected CPT code. The provider contract and claim details determine the actual reimbursement.

Run a free sample report
CPTDescriptionCategoryCigna National Avg.Medicare Benchmark
99214Office Visit, Established (Moderate)

E&M

View rates
99213Office Visit, Established (Low)

E&M

View rates
99215Office Visit, Established (High)

E&M

View rates
90837Psychotherapy, 60 min

Psychiatry

View rates
90834Psychotherapy, 45 min

Psychiatry

View rates
90791Psychiatric Diagnostic Evaluation

Psychiatry

View rates
70450CT Head/Brain without Contrast

Radiology

View rates
73721MRI Lower Extremity Joint

Radiology

View rates
45378Diagnostic Colonoscopy

Surgery

View rates

Rates shown are national averages. Actual Cigna reimbursement varies by affiliate, plan, geographic location, and provider contract. For provider-level detail by NPI or Tax ID, run a free sample report.

Cigna Machine Readable Files

How to read Cigna machine-readable files

Under the Transparency in Coverage requirements, most non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual coverage must publish machine-readable files with in-network negotiated rates and out-of-network allowed amounts and billed charges. See the CMS guidance for plans and issuers. CMS's technical clarification states that the files are updated monthly.

PayerPrice makes the Cigna records it tracks searchable by billing code, provider, plan, and market.

Search Cigna rates without opening raw files
cigna_in-network-rates_example.jsonILLUSTRATIVE
1{
2 "reporting_entity_name": "Cigna Healthcare",
3 "plan_name": "Cigna PPO",
4 "version": "1.3.0",
5 "in_network": [
6 { "billing_code": "99214",
7 "negotiated_rates": [
8 { "npi": 1538156793,
9 "negotiated_price": 162.84, "service_code": "11"
10 "billing_class": "professional" },
11 { "npi": 1972658421,
12 "negotiated_price": 148.20, "service_code": "11" },
13 // additional negotiated-rate rows
14 ]
15 },
16 // additional billing codes
17 ]
18}

rate observations in latest dataset

Frequently asked

Common questions about Cigna fee schedules

A Cigna fee schedule sets reimbursement terms for covered services in a provider agreement. The contract may use code-based prices or another payment method. PayerPrice organizes the published Cigna rate records it tracks for comparison.

For Cigna contract leads

Compare published Cigna rates for similar providers.

Start with a sample of published Cigna rate data, then narrow the comparison by plan, market, billing code, and provider attributes.

Your sample includes

Published rate records from Cigna

CPT and Medicare comparisons, where available

Filters for plan, market, and provider

Guidance for reading machine-readable files