What does Cigna pay for CPT 99213 in Illinois?

Based on Cigna's published Transparency in Coverage file, the median in-network office rate for CPT 99213 in Illinois is $88.70, with most rates falling between $34.72 and $126.35. This is drawn from 280 negotiated rates in the file.

How does that compare to Medicare?

Medicare's non-facility (office) allowed amount for CPT 99213 in Illinois is about $96.44. Cigna's median of $88.70 is roughly 92 percent of the Medicare rate.

If Cigna pays you below $88.70 for CPT 99213 in Illinois, you are being paid less than the middle of what they pay across the market. That does not automatically mean the contract is bad, but it usually means there is room to ask for more. A fee-schedule review will tell you where you stand.

What Cigna Pays for CPT 99213 in Illinois

Established patient office visit, low complexity. Office place of service. Straight from Cigna's own Transparency in Coverage file.

Median $88.70

92% of Medicare

280 rates

Office setting

Check Your Rate Call 888-701-6090

HIPAA Compliant

AAPC Certified

4.9/5 Rating

300+ Practices

Median rate

$88.70

across 280 published rates

Typical range

$34.72

25th percentile

$126.35

75th percentile

vs Medicare

92%

Medicare pays $96.44

What each payer pays for 99213 in Illinois

Same code, same office setting, same state. Every figure comes from that payer’s own Transparency in Coverage file.

Cignathis page

Open Access Plus national network (August 2026 TiC file)

$88.70

92% of Medicare

$34.72 to $126.35 middle range · 280 rates

UnitedHealthcare

Choice Plus national network (August 2026 TiC file)

$84.52

88% of Medicare

$73.87 to $104.51 middle range · 748 ratesDetail

Medicare

Non-facility allowed amount, Illinois

$96.44

These payers do not structure their files identically, so read the methodology before treating any single figure as your rate.

When a Illinois practice bills Cigna for CPT 99213, the file shows a median negotiated office rate of $88.70. Half of the rates in the file sit above that number and half below, and most cluster between $34.72 and $126.35. Against the Medicare office rate of $96.44 for the same code and state, the median lands at about 92 percent of Medicare.

The spread matters as much as the median. A wide gap between the 25th and 75th percentile means Cigna pays very differently for the same work depending on who negotiated the contract. If you are near the bottom of that range, the payer is already paying other Illinois practices more for identical claims, which is exactly the argument that moves a fee-schedule negotiation.

Rate Reality Check

See where your contracted rate falls against what this payer actually publishes.

What Cigna pays you for 99213 (per claim)

$34.72 (25th)$88.70 (median)$126.35 (75th)

Based on 280 published rates. Medicare pays about $96.44 here.

Get a free fee-schedule review

Keep digging

CPT 99213 coding and billing All Cigna rates How we build these numbers Fee-schedule negotiation

Paid Below $88.70 for 99213?

If Cigna pays your Illinois practice less than the median, we will benchmark the gap and take it back to the payer. Free review.

92%+ clean claim rate

2.49% starting rate

Results in 30 days

Fill in your details and we'll call you back

92% clean claim rate

7 years in business

HIPAA compliant

AAPC certified

Or call directly:888-701-6090

Turn This Number Into a Negotiation

A benchmark is only useful if someone acts on it. We renegotiate fee schedules for practices every week.

Get a Free Fee-Schedule Review Call 888-701-6090