CPT 12052 · professional fee

Intmd rpr face/mm 2.6-5.0 cm (CPT 12052): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 12052, from their published in-network rate files.

DermatologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$289

P10 to P90: $191 to $610

vs Medicare

93%

non-facility rate $311.96

Payer spread

1.59×

UHC $364 vs Aetna $229

State spread

3.7×

AK $768 to AZ $209

4,284 sampled providers5,606 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 12052 in the files analyzed, at $364, 59% above Aetna ($229), the lowest of the 4 payers shown.

The state spread is 3.7×: Alaska has the highest median at $768 and Arizona the lowest at $209, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 93% of the Medicare non-facility rate ($311.96), which ranks 210th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $87) and widest within UnitedHealthcare ($271).

This is a top-29 code for dermatology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$364	$293	$564	+26%	1	3,645	117% of Medicare
Cigna	$289	$222	$412	+0%	2	3,528	93% of Medicare
Blue Cross Blue Shield	$282	$225	$381	-3%	3	3,308	90% of Medicare
Aetna	$229	$192	$279	-21%	4	2,956	73% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($311.96)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$768	+166%	n/a	n/a	16
2	Wisconsin	$609	+110%	UHC	Aetna	103
3	Nebraska	$467	+62%	UHC	BCBS	48
3	South Dakota	$467	+62%	UHC	BCBS	37
5	Oregon	$455	+57%	UHC	Aetna	108
6	New Hampshire	$439	+52%	UHC	Aetna	78
7	Massachusetts	$438	+52%	UHC	Aetna	116
8	Washington	$434	+50%	UHC	Aetna	106
9	Minnesota	$433	+50%	BCBS	Aetna	116
10	Iowa	$415	+43%	UHC	BCBS	63
11	Hawaii	$412	+42%	Cigna	UHC	41
12	North Dakota	$405	+40%	n/a	n/a	24
13	Georgia	$404	+40%	UHC	Aetna	116
14	Maine	$403	+39%	UHC	Aetna	41
15	Mississippi	$373	+29%	BCBS	Cigna	55
16	Vermont	$346	+20%	UHC	BCBS	21
17	Rhode Island	$314	+9%	UHC	Aetna	48
18	Montana	$314	+9%	UHC	Cigna	43
19	Connecticut	$313	+8%	UHC	Aetna	109
20	Idaho	$313	+8%	BCBS	Aetna	46
21	Kansas	$309	+7%	UHC	Aetna	73
22	Illinois	$308	+6%	UHC	Cigna	113
23	Arkansas	$300	+4%	UHC	Aetna	65
24	Colorado	$299	+4%	UHC	Aetna	125
25	Utah	$295	+2%	UHC	Aetna	113
26	West Virginia	$294	+2%	Cigna	Aetna	31
27	Nevada	$288	-0%	UHC	Aetna	65
28	New York	$287	-1%	UHC	Aetna	106
29	New Mexico	$286	-1%	UHC	Aetna	33
30	Pennsylvania	$280	-3%	UHC	Aetna	116
31	Louisiana	$276	-5%	UHC	Aetna	130
32	Texas	$275	-5%	UHC	Aetna	134
33	Ohio	$275	-5%	UHC	Aetna	115
34	North Carolina	$274	-5%	UHC	Aetna	125
35	Tennessee	$274	-5%	UHC	Cigna	123
36	Missouri	$271	-6%	UHC	Aetna	118
37	Michigan	$267	-8%	UHC	Aetna	108
38	California	$262	-10%	UHC	BCBS	98
39	Oklahoma	$260	-10%	UHC	Aetna	80
40	Delaware	$259	-10%	UHC	Aetna	18
41	South Carolina	$255	-12%	UHC	Aetna	106
42	District of Columbia	$242	-16%	UHC	Aetna	36
42	Virginia	$242	-16%	UHC	BCBS	121
44	New Jersey	$242	-16%	UHC	Aetna	99
45	Kentucky	$234	-19%	UHC	Aetna	112
46	Indiana	$233	-19%	UHC	Aetna	116
47	Maryland	$231	-20%	UHC	BCBS	109
48	Alabama	$222	-23%	UHC	BCBS	131
49	Florida	$219	-24%	BCBS	Aetna	114
50	Arizona	$209	-28%	UHC	BCBS	104

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 12052?

In the files we analyzed, UnitedHealthcare, at a median of $364 across 3,645 sampled providers. Aetna is lowest at $229, 59% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 93% of the 2026 Medicare non-facility rate of $311.96.

Which state has the highest median for CPT 12052?

Alaska has the highest median at $768; Arizona has the lowest at $209.

Is this the surgeon, physician or facility payment?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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