Cardiovascular Disease reimbursement rates by service line
Compare payer-published cardiovascular disease benchmarks for office visits; ECG; echocardiography; stress testing; catheterization.
Compare national cardiovascular disease rates by payer
Use the reference codes to compare payer benchmarks, then explore office visits; ECG; echocardiography; stress testing; catheterization. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 99214
National 99214 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National 99214 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 57,892 | $110.65 | $127.44 | |||
| Cigna | Jun–Jul 2026 | 60,515 | $153.50 | $170.71 | |||
| United | Jun–Jul 2026 | 61,658 | $163.77 | $181.93 | |||
| Anthem | Jun–Jul 2026 | 51,184 | $147.40 | $173.31 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for established patient office visit, level 4 (99214).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific cardiovascular disease providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Cardiovascular Disease provider benchmarks (CPT 99214)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| BAY AREA HEART CENTER PANPI 1144213422 · Tax ID 592291897 | FL | 29 | $66.26 | -$44.40 | Below P25 |
| BAMA HEART DOC PCNPI 1225086416 · Tax ID 451471722 | WA | 11 | $84.15 | -$26.50 | Below P25 |
| CENTRA OBSERVATION SPECIALISTS LLCNPI 1922230978 · Tax ID 472593880 | VA | 60 | $93.37 | -$17.28 | Below P25 |
| SYMPHONY MEDICAL PCNPI 1467914556 · Tax ID 471235609 | NY | 108 | $100.35 | -$10.30 | P25 to median |
| MEDICAL ASSOCIATES OF BREVARD, LLCNPI 1134191323 · Tax ID 593360315 | FL | 179 | Median to P75 | ||
| ATLANTIC MEDICAL IMAGING, LLCNPI 1255390944 · Tax ID 222222502 | NJ | 189 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore cardiovascular disease services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 7 codes | ||||
99214Established patient office visit, level 4 | $127.44 | $170.71 | $181.93 | $173.31 |
99213Established patient office visit, level 3 | $87.22 | $117.66 | $125.78 | $122.06 |
99204New patient office visit, level 4 | $183.22 | $246.93 | $269.12 | $263.78 |
99215Established patient office visit, level 5 | $178.46 | $244.48 | $247.14 | $247.44 |
99203New patient office visit, level 3 | $117.90 | $159.19 | $177.94 | $172.63 |
99212Established patient office visit, level 2 | $51.82 | $70.01 | $77.17 | $75.21 |
99205New patient office visit, level 5 | $238.17 | $320.29 | $342.48 | $340.64 |
$ per reported billing unit · 12 codes | ||||
93010Heart Test Review And Report | $12.35 | $16.25 | $15.64 | $19.25 |
93000Routine electrocardiogram with interpretation and report | $24.27 | $32.36 | $31.49 | $42.23 |
93306Complete transthoracic echocardiography with Doppler | $317.80 | $414.76 | $414.91 | $527.33 |
93015Cardiovascular Stress Test | $114.85 | $151.46 | $144.18 | $191.97 |
93018Cardiovascular Stress Test | $21.60 | $28.54 | $28.77 | $34.44 |
93005Electrocardiogram Routine Ecg | $11.80 | $35.42 | $15.77 | $21.98 |
93325Add-On Test Heart Ultrasound | $45.01 | $64.03 | $58.42 | $92.28 |
93016Stress Test Supervision | $32.59 | $42.61 | $42.51 | $50.98 |
93458Coronary angiography with left heart catheterization | $1,541.66 | $2,054.26 | $2,090.35 | $2,512.70 |
93308Ultrasound Of Heart | $155.74 | $202.75 | $200.53 | $242.71 |
93320Doppler Echocardiography Puls | $84.22 | $110.33 | $108.28 | $145.52 |
93280Programming Device Evaluation (In Person) With Iterative Adjustment Of The Implantable Device To Test The Function Of The Device And Select Optimal Permanent Programmed Values With Analysis Review And Report By A Physician Or Other Qualified Health Care Professional; Dual Lead Pacemaker System (Revised 01/01/13) | $108.24 | $142.60 | $130.03 | $152.06 |
$ per reported billing unit · 1 code | ||||
78452Ht Muscle Image Spect Mult | $607.49 | $799.26 | $824.12 | $984.81 |
Tell us the services, payers, states, and networks you need. We'll confirm available coverage and scope the comparison on a 20-minute call.
Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
Get the cardiovascular disease reimbursement data you're looking for
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We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
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Explore cardiovascular disease rates by state
Choose a state to compare payer reference averages for common services.
Questions about cardiovascular disease benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Established patient office visit, level 4 (99214). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.