CPT 17313 · professional fee

Mohs 1 stage t/a/l (CPT 17313): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 17313, from their published in-network rate files.

DermatologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee
Median rate
$515
P10 to P90: $305 to $1,144
vs Medicare
200%
facility rate $257.52
Payer spread
2.02×
UHC $740 vs Aetna $367
State spread
4.0×
AK $1,274 to AL $322
4,280 sampled providers5,613 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers
1

UnitedHealthcare has the highest median for CPT 17313 in the files analyzed, at $740, 102% above Aetna ($367), the lowest of the 4 payers shown.

2

The state spread is 4.0×: Alaska has the highest median at $1,274 and Alabama the lowest at $322, a gap larger than the gap between the highest and lowest payer.

3

Commercial rates run 200% of the Medicare facility rate ($257.52), which ranks 35th of 228 tracked codes by commercial-to-Medicare ratio.

4

Rates are tightest within Aetna (interquartile range $152) and widest within Cigna ($348).

5

This is a top-8 code for dermatology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

6

The Medicare comparison uses the facility rate: the non-facility rate ($626.27) is 2.4× higher because it includes device or supply cost that professional-fee contracts do not.

Rates by payer

Median of per-provider median rates, with interquartile range
PayerMedianP25P75vs nationalRankProvidersPosition
UnitedHealthcare$740$596$1,132+44%13,623
287% of Medicare
Blue Cross Blue Shield$508$372$673-1%23,330
197% of Medicare
Cigna$452$340$688-12%33,491
176% of Medicare
Aetna$367$305$457-29%42,856
142% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($257.52)
$232$523$813$1,104$1,395$1,686UnitedHealthcareBlue Cross Blue ShieldCignaAetnaMedicare

Rates by state

Median across payers · 50 states with enough data
RankStateMedianvs nationalHighest payerLowest payerProvidersLevel
1Alaska$1,274+148%n/an/a16
2Wisconsin$1,048+104%UHCAetna103
3Oregon$865+68%UHCAetna108
4Hawaii$845+64%CignaUHC41
5Minnesota$814+58%UHCAetna116
6Nebraska$811+58%UHCBCBS48
7Washington$797+55%UHCAetna106
8New Hampshire$789+53%UHCAetna78
9South Dakota$764+48%UHCBCBS37
10Massachusetts$756+47%UHCAetna116
11Maine$713+38%UHCAetna41
12North Dakota$702+36%n/an/a24
13Iowa$693+35%CignaAetna63
14Georgia$654+27%UHCCigna115
15Mississippi$637+24%BCBSCigna55
16New York$617+20%UHCAetna107
17Vermont$600+17%UHCCigna21
18Pennsylvania$590+15%UHCAetna117
19West Virginia$582+13%UHCCigna31
20North Carolina$569+11%BCBSAetna125
21Connecticut$554+8%UHCAetna109
22Illinois$553+7%UHCCigna113
23Rhode Island$542+5%UHCAetna48
24Nevada$530+3%UHCAetna65
25Kansas$514-0%UHCAetna73
26Idaho$512-0%UHCAetna46
27Ohio$510-1%UHCAetna115
28Missouri$500-3%UHCAetna118
29Montana$496-4%UHCBCBS42
30Utah$490-5%UHCAetna113
30New Mexico$490-5%UHCAetna33
32Kentucky$480-7%UHCAetna112
33Tennessee$479-7%UHCCigna123
34Louisiana$478-7%UHCCigna130
35Colorado$466-9%UHCAetna125
36Arkansas$452-12%UHCAetna64
37Texas$446-13%UHCAetna134
38South Carolina$444-14%BCBSAetna107
39California$441-14%UHCAetna97
40Delaware$439-15%UHCAetna18
41New Jersey$433-16%UHCAetna99
42Michigan$426-17%UHCAetna108
43Oklahoma$422-18%UHCAetna80
44Virginia$406-21%UHCBCBS121
45Maryland$384-25%UHCBCBS108
46Indiana$378-27%UHCAetna116
47Florida$371-28%UHCAetna112
48District of Columbia$342-33%UHCCigna36
49Arizona$330-36%UHCBCBS104
50Alabama$322-37%UHCAetna131

Frequently asked questions

Answers use this page's data
Which payer has the highest median rate for CPT 17313?

In the files we analyzed, UnitedHealthcare, at a median of $740 across 3,623 sampled providers. Aetna is lowest at $367, 102% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 200% of the 2026 Medicare facility rate of $257.52.

Which state has the highest median for CPT 17313?

Alaska has the highest median at $1,274; Alabama has the lowest at $322.

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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