CPT 20550 · professional fee

Njx 1 tendon sheath/ligament (CPT 20550): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 20550, from their published in-network rate files.

Orthopedic surgerySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$74

P10 to P90: $46 to $134

vs Medicare

122%

non-facility rate $60.46

Payer spread

1.68×

UHC $97 vs Aetna $57

State spread

4.2×

AK $235 to TX $57

5,067 sampled providers6,187 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 20550 in the files analyzed, at $97, 68% above Aetna ($57), the lowest of the 4 payers shown.

The state spread is 4.2×: Alaska has the highest median at $235 and Texas the lowest at $57, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 122% of the Medicare non-facility rate ($60.46), which ranks 164th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $22) and widest within UnitedHealthcare ($54).

This is a top-33 code for orthopedic surgery 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	$97	$74	$128	+31%	1	4,263	160% of Medicare
Cigna	$73	$59	$91	-1%	2	4,048	120% of Medicare
Blue Cross Blue Shield	$73	$56	$95	-2%	3	3,953	120% of Medicare
Aetna	$57	$48	$70	-22%	4	3,236	95% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($60.46)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$235	+219%	UHC	BCBS	65
2	Wisconsin	$114	+55%	UHC	Aetna	100
3	Wyoming	$111	+51%	UHC	Cigna	65
4	Nebraska	$108	+46%	UHC	Aetna	95
5	District of Columbia	$100	+35%	UHC	BCBS	35
6	Connecticut	$93	+26%	UHC	Aetna	114
7	Washington	$91	+24%	UHC	Aetna	101
8	South Dakota	$91	+24%	UHC	BCBS	97
9	North Dakota	$91	+23%	UHC	Aetna	46
10	Minnesota	$90	+22%	UHC	Aetna	102
11	New Jersey	$90	+21%	UHC	Aetna	96
11	Oregon	$90	+21%	UHC	Aetna	93
13	Iowa	$89	+21%	UHC	Aetna	104
14	Mississippi	$86	+17%	BCBS	Cigna	112
15	Georgia	$86	+17%	UHC	Aetna	124
16	North Carolina	$85	+15%	UHC	Aetna	128
17	Massachusetts	$83	+13%	UHC	Aetna	111
18	Vermont	$82	+12%	UHC	BCBS	35
19	Tennessee	$82	+11%	UHC	Aetna	115
20	South Carolina	$80	+8%	UHC	Aetna	106
21	Idaho	$77	+5%	UHC	Cigna	120
22	Pennsylvania	$75	+1%	UHC	Aetna	104
23	Hawaii	$74	+1%	BCBS	Cigna	69
24	Rhode Island	$74	+0%	UHC	Aetna	98
25	Maine	$74	+0%	UHC	BCBS	94
26	New Hampshire	$73	-1%	UHC	Aetna	118
27	Colorado	$73	-1%	UHC	Aetna	107
28	New York	$73	-2%	UHC	Aetna	111
29	Indiana	$72	-2%	UHC	Aetna	115
30	Arkansas	$69	-6%	UHC	Aetna	119
31	Delaware	$69	-6%	BCBS	Aetna	59
32	Maryland	$69	-7%	UHC	BCBS	106
33	Kentucky	$68	-8%	UHC	Aetna	124
34	West Virginia	$67	-9%	UHC	BCBS	89
35	Illinois	$66	-10%	UHC	Cigna	105
36	Nevada	$66	-11%	BCBS	Aetna	108
37	Louisiana	$66	-11%	UHC	BCBS	103
38	Missouri	$65	-11%	UHC	Aetna	112
39	New Mexico	$64	-13%	UHC	BCBS	105
40	Virginia	$64	-13%	UHC	BCBS	104
41	Kansas	$63	-14%	UHC	Aetna	108
42	Ohio	$63	-15%	UHC	Aetna	110
43	Arizona	$63	-15%	UHC	BCBS	99
44	California	$62	-15%	UHC	Aetna	109
45	Montana	$61	-17%	UHC	Cigna	79
45	Alabama	$61	-17%	UHC	BCBS	118
47	Utah	$61	-17%	UHC	BCBS	97
48	Oklahoma	$60	-19%	UHC	Aetna	100
49	Michigan	$57	-22%	UHC	BCBS	103
50	Florida	$57	-23%	UHC	Aetna	108
51	Texas	$57	-23%	UHC	Aetna	122

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 20550?

In the files we analyzed, UnitedHealthcare, at a median of $97 across 4,263 sampled providers. Aetna is lowest at $57, 68% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 122% of the 2026 Medicare non-facility rate of $60.46.

Which state has the highest median for CPT 20550?

Alaska has the highest median at $235; Texas has the lowest at $57.

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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