# Payer Fee Schedules 2026: How to Get Yours

> Why there is no single commercial fee schedule, where each payer publishes its negotiated rates under Transparency in Coverage, three ways to get your own 2026 rates, and a link to every payer RateBench reads.

- Published: 2026-10-10
- Author: RateBench
- Human page: https://ratebench.health/blog/payer-fee-schedules-2026
- This document: https://ratebench.health/blog/payer-fee-schedules-2026.md
- Product (sign up / app): https://app.ratebench.health

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Commercial payers rarely publish one fee schedule that applies to every practice,
because there isn't one. Each practice's rates are negotiated, so each practice
has its own schedule. The good news is that since July 2022, those negotiated
rates are public.

## Why there's no single "Aetna fee schedule" or "Cigna fee schedule"

A fee schedule is the list of amounts a payer has agreed to pay a specific
provider for each service code. Two family practices in the same town can have
different rates for 99214 from the same payer, depending on when they signed,
which network they joined and how they negotiated.

So when a payer says it can't send "the fee schedule", it usually means it can't
send a universal one. It can tell you your own rates, but getting them through
provider relations can take weeks.

The exceptions are government programs. Medicare publishes one national fee
schedule with local adjustments, and each state Medicaid program publishes its
own. Our [Medicaid fee schedules by state](/blog/medicaid-fee-schedules-by-state)
guide lists where each state posts them.

## Where commercial rates are published now

The federal Transparency in Coverage rules (85 FR 72158, published 12 November
2020) require most group health plans and insurers to publish their in-network
negotiated rates in machine-readable files. The files have been required since
plan years beginning on or after 1 July 2022, and plans must update them monthly.

The files list, for each provider and billing code, the rate the payer
negotiated. If you're in network, your 2026 rates are in there, under your NPI or
your group's tax ID.

The catch is size. A large payer publishes hundreds of files a month: Aetna
posted 288 in-network files for September 2026, and Cigna 120 (as checked on 21
and 23 September 2026). Each is compressed JSON meant for software, not people.
Opening one in a spreadsheet won't work.

## Three ways to get your 2026 rates

- **Ask the payer.** Call provider relations or use the provider portal, and ask for your current fee schedule for the codes you bill most, in writing, with an effective date. It's free and authoritative, but slow, and you may get only a handful of codes.
- **Check your contract.** Some contracts include a fee schedule exhibit; many instead say rates are "a percentage of the payer's standard schedule", which you then have to request anyway. Our guide to [finding your contracted rate by CPT code](/blog/find-your-contracted-rate) covers what to look for.
- **Read the payer's published file.** This is what RateBench does. Pick your payer below, enter your NPI in the free lookup on its page, and we send the rates that payer published for your NPI, with the file month and source.

## What payers publish: one example

To show what these files contain, here are the middle published rates for 99214,
an established-patient office visit, at five payers, from their September 2026
files. These are typical rates across the provider groups in each file, not
your rate.

| Payer | 99214 middle rate | Middle half |
|---|---|---|
| [Cigna](/rates/cigna/99214) | $131.54 | $102.07–$179.60 |
| [Aetna](/rates/aetna/99214) | $119.54 | $89.71–$166.75 |
| [UnitedHealthcare](/rates/uhc/99214) | $115.27 | $96.15–$147.69 |
| [Florida Blue](/rates/floridablue/99214) | $98.18 | $94.51–$112.20 |
| [BCBS Texas](/rates/bcbstx/99214) | $90.75 | $64.83–$100.87 |

Source: each payer's in-network rate files, September 2026, as read by RateBench
(snapshot of 23 September 2026). The middle half runs from the 25th to the 75th
percentile. At Aetna, groups that list more than one rate for the code are left
out rather than averaged.

The spread is the point. Within one payer, the middle half for 99214 spans more
than $75 at Cigna. Whether you sit at the low or high end of that range is worth
knowing before your next renewal. For all seven payers we publish typical rates
for, see [99214 reimbursement rates by payer](/blog/99214-reimbursement-rate-2026).

## Blue Cross Blue Shield is different

There is no single "BCBS fee schedule". Each Blue plan is a separate company with
its own files and rates, so a practice in Texas and one in Florida deal with
different plans. See [Blue Cross Blue Shield fee schedules](/blog/blue-cross-blue-shield-fee-schedule)
for how to find your local plan.

## Fee schedules by payer

We read 66 payers today: the local Blue plan in 49 states and DC, plus UnitedHealthcare, Aetna, Cigna, Ambetter, Oscar and Medicare. Each page explains
where that payer's rates come from and has the free lookup for your NPI.

| Payer | Where |
|---|---|
| [Aetna](/payers/aetna) | Nationwide |
| [Cigna](/payers/cigna) | Nationwide |
| [UnitedHealthcare](/payers/uhc) | Nationwide |
| [Medicare](/payers/medicare) | Nationwide |
| [Ambetter](/payers/ambetter) | 28 states |
| [Oscar](/payers/oscar) | 20 states |
| [Fidelis Care](/payers/fidelis) | New York |
| [BCBS Illinois](/payers/bcbsil) | Illinois |
| [BCBS Texas](/payers/bcbstx) | Texas |
| [BCBS Oklahoma](/payers/bcbsok) | Oklahoma |
| [BCBS New Mexico](/payers/bcbsnm) | New Mexico |
| [BCBS Montana](/payers/bcbsmt) | Montana |
| [Highmark BCBS Pennsylvania](/payers/highmark-pa) | Pennsylvania |
| [Highmark Blue Shield Pennsylvania](/payers/highmark-bs-pa) | Pennsylvania |
| [Highmark BCBS Delaware](/payers/highmark-de) | Delaware |
| [Highmark BCBS West Virginia](/payers/highmark-wv) | West Virginia |
| [Highmark BCBS Western New York](/payers/highmark-wny) | New York |
| [Highmark Blue Shield Northeastern New York](/payers/highmark-neny) | New York |
| [BCBS North Dakota](/payers/bcbsnd) | North Dakota |
| [BCBS Wyoming](/payers/bcbswy) | Wyoming |
| [UPMC Health Plan](/payers/upmc) | Pennsylvania |
| [Anthem Blue Cross California](/payers/anthem-ca) | California |
| [Anthem BCBS Colorado](/payers/anthem-co) | Colorado |
| [Anthem BCBS Connecticut](/payers/anthem-ct) | Connecticut |
| [Anthem BCBS Georgia](/payers/anthem-ga) | Georgia |
| [Anthem BCBS Indiana](/payers/anthem-in) | Indiana |
| [Anthem BCBS Kentucky](/payers/anthem-ky) | Kentucky |
| [Anthem BCBS Maine](/payers/anthem-me) | Maine |
| [Anthem BCBS Missouri](/payers/anthem-mo) | Missouri |
| [Anthem BCBS Nevada](/payers/anthem-nv) | Nevada |
| [Anthem BCBS New Hampshire](/payers/anthem-nh) | New Hampshire |
| [Anthem BCBS New York (Empire)](/payers/anthem-ny) | New York |
| [Anthem BCBS Ohio](/payers/anthem-oh) | Ohio |
| [Anthem BCBS Virginia](/payers/anthem-va) | Virginia |
| [Anthem BCBS Wisconsin](/payers/anthem-wi) | Wisconsin |
| [BCBS Michigan](/payers/bcbsm) | Michigan |
| [Horizon BCBS New Jersey](/payers/horizon) | New Jersey |
| [Blue Cross of Idaho](/payers/bcidaho) | Idaho |
| [BCBS Louisiana](/payers/bcbsla) | Louisiana |
| [Blue KC (Kansas City)](/payers/bcbskc) | Missouri, Kansas |
| [Premera Blue Cross](/payers/premera) | Washington, Alaska |
| [Wellmark BCBS](/payers/wellmark) | Iowa, South Dakota |
| [Blue Shield of California](/payers/bsca) | California |
| [MVP Health Care](/payers/mvp) | New York, Vermont |
| [Sentara Health Plans](/payers/sentara) | Virginia, North Carolina |
| [EmblemHealth](/payers/emblem) | New York |
| [Excellus BCBS](/payers/excellus) | New York |
| [BCBS Nebraska](/payers/bcbsnebraska) | Nebraska |
| [BCBS Arizona](/payers/azblue) | Arizona |
| [Regence BCBS Oregon](/payers/regence-or) | Oregon |
| [Regence BCBS Utah](/payers/regence-ut) | Utah |
| [Regence BlueShield Idaho](/payers/regence-id) | Idaho |
| [Regence BlueShield Washington](/payers/regence-wa) | Washington |
| [CareFirst BCBS (PPO)](/payers/carefirst) | Maryland, District of Columbia, Virginia |
| [CareFirst BlueChoice (HMO)](/payers/carefirst-hmo) | Maryland, District of Columbia, Virginia |
| [BCBS Minnesota](/payers/bcbsmn) | Minnesota |
| [BCBS North Carolina](/payers/bcbsnc) | North Carolina |
| [BCBS Tennessee](/payers/bcbst) | Tennessee |
| [BCBS Massachusetts](/payers/bcbsma) | Massachusetts |
| [BCBS South Carolina](/payers/bcbssc) | South Carolina |
| [Florida Blue](/payers/floridablue) | Florida |
| [BCBS Rhode Island](/payers/bcbsri) | Rhode Island |
| [BCBS Vermont](/payers/bcbsvt) | Vermont |
| [Arkansas BCBS](/payers/arkansasbcbs) | Arkansas |
| [BCBS Alabama](/payers/bcbsal) | Alabama |
| [BCBS Mississippi](/payers/bcbsms) | Mississippi |

Don't see yours? The [payer list](/payers) shows coverage by state.

## What to do with your rates

- **Check them against what you're paid.** Compare each code's rate with the allowed amounts on your remittances. A gap on a high-volume code adds up fast; [how to spot underpayments by CPT code](/blog/spot-underpayments-by-cpt-code) walks through it.
- **Compare payers.** If one payer pays 30% less for the same visit, that's the contract to look at first.
- **Watch for changes.** Payers republish monthly, and a rate can change without a letter.

## Get your rates free

Pick your payer from the table above and run the free lookup: enter your NPI and
email, and we send the published rates for the six codes your specialty bills
most. No account or card is needed.

## Common questions

### Is a payer’s fee schedule public?

The negotiated rates are. Since plan years beginning on or after July 1, 2022, most commercial health plans must publish their in-network rates in machine-readable files, updated monthly. A single fee schedule that applies to every practice doesn’t exist, because each practice’s rates are negotiated.

### Can I get the 2026 Medicare fee schedule the same way?

No. Medicare sets its own Physician Fee Schedule, adjusted by location, and publishes it on CMS.gov. RateBench shows the Part B amount for your own pricing area alongside the commercial payers’ published rates.

### Are the rates in the files the same as my contract?

They are what the payer reports it negotiated with your NPI or tax ID. If they differ from your contract, that’s worth raising with the payer.

### How often do the files change?

The rules require plans to update them monthly, and a rate can change without a letter.

## Sources

1. Federal Register / U.S. Departments of the Treasury, Labor and HHS (November 12, 2020). "Transparency in Coverage, final rules (85 FR 72158)". https://www.federalregister.gov/documents/2020/11/12/2020-24591/transparency-in-coverage
2. CMS (accessed October 2026). "price-transparency-guide: technical implementation guide and in-network rates schema". https://github.com/CMSgov/price-transparency-guide
3. CMS (accessed October 2026). "Physician Fee Schedule look-up tool". https://www.cms.gov/medicare/physician-fee-schedule/search
4. RateBench (generated September 23, 2026). "Typical-rates snapshot from seven payers’ September 2026 in-network files". https://ratebench.health/payers