CPT 99214
Established patient office visit, level 4
- Aetna
- $136.69
- Cigna
- $149.04
- United
- $176.28
- Anthem
- $231.95
Pulmonary Disease reimbursement rates in Delaware
Explore pulmonary disease reimbursement rates in Delaware. Public state reference averages appear below. Detailed payer comparisons are available with a state preview.
2,062,666 national provider-rate observations4 payers in national source data50 states in national dataset20 billing codes in national dataset
Rate data shownJun–Jul 2026About these rates
Pulmonary Disease rate explorerThree reference services
Rate measure$ per reported billing unit
Billing contextProfessional
Delaware pulmonary disease reference averages
Publication period: Jun–Jul 2026CPT 94010
Spirometry
- Aetna
- $43.27
- Cigna
- $40.01
- United
- $56.16
- Anthem
- $74.51
CPT 94729
Pulmonary diffusing capacity test
- Aetna
- $88.32
- Cigna
- $76.56
- United
- $92.03
- Anthem
- $153.29
National pulmonary disease rates by payer
Use the reference codes to compare payer benchmarks, then explore office visits; pulmonary testing; hospital care; sleep context. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 99214
LowerHigher
Delaware
Select a state to reveal payer percentiles and provider examples.National 99214 rate distribution
PayerMedian
Published rate$ per reported billing unit
$100$120$140$160$180
AetnaJun–Jul 2026
AetnaProviders25,239Average$126.47
$109.20median
CignaJun–Jul 2026
CignaProviders26,217Average$170.93
$154.65median
UnitedJun–Jul 2026
UnitedProviders26,505Average$184.15
$166.99median
AnthemJun–Jul 2026
AnthemProviders23,376Average$181.03
$149.78median
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 | 25,239 | $109.20 | $126.47 | |||
| Cigna | Jun–Jul 2026 | 26,217 | $154.65 | $170.93 | |||
| United | Jun–Jul 2026 | 26,505 | $166.99 | $184.15 | |||
| Anthem | Jun–Jul 2026 | 23,376 | $149.78 | $181.03 |
About these rates
About this rate table
- 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 pulmonary disease providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Pulmonary Disease provider benchmarks (CPT 99214)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| CARLE HEALTH CARE INCORPORATEDNPI 1154653947 · Tax ID 371140016 | IL | 2,236 | $65.03 | -$44.17 | Below P25 |
| BIRMINGHAM PULMONARY GROUPPCNPI 1275574295 · Tax ID 630717705 | AL | 7 | $84.15 | -$25.05 | Below P25 |
| URMILA SHIVARAMNPI 1215025473 | NY | - | $93.64 | -$15.56 | Below P25 |
| DS MEDICAL DIAGNOSTICS PCNPI 1336171040 · Tax ID 830933188 | NY | 6 | $100.65 | -$8.55 | P25 to median |
| SOUTHCOAST HOSPITALS GROUP INCNPI 1073670303 · Tax ID 222592333 | MA | 329 | Median to P75 | ||
| LAWRENCE MEDICAL ASSOCIATES PCNPI 1093081911 · Tax ID 264076297 | NY | 671 | Above P75 |
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No trial or data preparation required.Explore pulmonary 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 · 13 codes | ||||
99214Established patient office visit, level 4 | $126.47 | $170.93 | $184.15 | $181.03 |
99213Established patient office visit, level 3 | $86.33 | $117.73 | $127.55 | $126.66 |
99233Subsequent hospital inpatient or observation care, level 3 | $124.16 | $179.15 | $176.69 | $189.49 |
99232Subsequent hospital inpatient or observation care, level 2 | $90.21 | $122.11 | $121.50 | $130.75 |
99204New patient office visit, level 4 | $182.03 | $246.86 | $271.35 | $272.16 |
99215Established patient office visit, level 5 | $177.17 | $244.18 | $250.98 | $253.33 |
99223Initial hospital inpatient or observation care, level 3 | $214.90 | $309.47 | $318.97 | $342.14 |
99203New patient office visit, level 3 | $117.03 | $159.01 | $179.31 | $177.67 |
99222Initial hospital inpatient or observation care, level 2 | $155.50 | $220.55 | $222.63 | $239.67 |
99205New patient office visit, level 5 | $236.56 | $322.16 | $345.85 | $350.81 |
99239Hospital discharge management, more than 30 minutes | $125.61 | $179.13 | $179.17 | $194.40 |
99212Established patient office visit, level 2 | $51.35 | $69.80 | $78.19 | $76.60 |
99231Subsequent hospital inpatient or observation care, level 1 | $63 | $71.44 | $68.78 | $75.42 |
$ per reported billing unit · 6 codes | ||||
94729Pulmonary diffusing capacity test | $79.96 | $106.46 | $103.01 | $123.33 |
94060Bronchodilator responsiveness | $69.67 | $90.12 | $99.04 | $113.51 |
94726Whole-Body Air Volume Test | $77.89 | $104.47 | $99.73 | $123.62 |
94010Spirometry | $44.28 | $57.54 | $60.78 | $70.11 |
94727Gas dilution or washout for determination of lung volumes | $62.14 | $82.98 | $80.22 | $98.35 |
95810Overnight Sleep Study | $937.61 | $1,197.94 | $1,173.81 | $1,486.01 |
$ per reported billing unit · 1 code | ||||
71046Chest X-ray, two views | $43.51 | $56.85 | $54.32 | $73.90 |
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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.
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Explore pulmonary disease rates by state
Choose a state to compare payer reference averages for common services.
Questions about pulmonary 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.