Endocrinology reimbursement rates in New York
What UnitedHealthcare and Cigna have actually negotiated for the codes a endocrinology practice bills in New York, taken from the payers’ own federal Transparency in Coverage filings and compared against Medicare.
| CPT | UnitedHealthcare | Cigna | Medicare | Best vs Medicare |
|---|---|---|---|---|
| 99457 | $57.13 | $74.85 | $56.69 | 132% |
| 99458 | $46.62 | $60.35 | $45.14 | 134% |
| 99490 | $49.70 | $73.51 | $72.07 | 102% |
| 99215 | $173.68 | $226.61 | $209.96 | 108% |
| 99204 | $192.08 | $223.83 | $193.89 | 115% |
| 99214 | $129.67 | $156.99 | $148.05 | 106% |
| 99213 | $89.99 | $107.48 | $103.97 | 103% |
| 99491 | $89.18 | $120.02 | $96.80 | 124% |
Median negotiated rate per code, office place of service. A published rate is a benchmark, not a guarantee of your rate. Method at our rates methodology.
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These are negotiated rates, not payments. What reaches your account also depends on eligibility, medical necessity, bundling edits and whether the claim survives adjudication. Half the negotiated rates in New York sit above the figures shown and half below, and where you fall depends on your group size and what you signed.