CPT 22558 · professional fee

Arthrd ant ntrbd min dsc lum (CPT 22558): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 22558, 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

$2,471

P10 to P90: $1,580 to $4,365

vs Medicare

174%

non-facility rate $1,423.88

Payer spread

1.33×

UHC $2,718 vs Aetna $2,036

State spread

3.8×

AK $6,915 to CA $1,810

5,036 sampled providers6,066 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 22558 in the files analyzed, at $2,718, 33% above Aetna ($2,036), the lowest of the 4 payers shown.

The state spread is 3.8×: Alaska has the highest median at $6,915 and California the lowest at $1,810, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 174% of the Medicare non-facility rate ($1,423.88), which ranks 79th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Blue Cross Blue Shield (interquartile range $1,174) and widest within UnitedHealthcare ($1,518).

This is a top-35 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	$2,718	$2,051	$3,568	+10%	1	4,263	191% of Medicare
Blue Cross Blue Shield	$2,503	$1,903	$3,077	+1%	2	3,862	176% of Medicare
Cigna	$2,503	$2,010	$3,291	+1%	2	4,048	176% of Medicare
Aetna	$2,036	$1,584	$2,638	-18%	4	2,539	143% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($1,423.88)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$6,915	+180%	Aetna	BCBS	65
2	Wisconsin	$3,987	+61%	BCBS	Aetna	100
3	Wyoming	$3,528	+43%	BCBS	UHC	65
4	South Dakota	$3,416	+38%	UHC	Cigna	97
5	District of Columbia	$3,256	+32%	Aetna	BCBS	35
6	Washington	$3,230	+31%	UHC	Aetna	100
7	Connecticut	$3,216	+30%	UHC	Aetna	114
8	Nebraska	$3,204	+30%	Cigna	BCBS	95
9	Iowa	$3,171	+28%	UHC	Aetna	104
10	New Jersey	$3,065	+24%	Cigna	BCBS	95
11	North Dakota	$3,038	+23%	BCBS	UHC	45
12	Oregon	$3,019	+22%	UHC	Aetna	91
13	Massachusetts	$2,967	+20%	UHC	Aetna	111
14	Mississippi	$2,960	+20%	Aetna	Cigna	112
15	Georgia	$2,795	+13%	UHC	BCBS	124
16	Tennessee	$2,777	+12%	Aetna	Cigna	114
17	North Carolina	$2,752	+11%	UHC	Aetna	128
18	Rhode Island	$2,711	+10%	UHC	Aetna	98
19	Illinois	$2,633	+7%	UHC	BCBS	103
20	Vermont	$2,606	+5%	UHC	BCBS	35
21	Idaho	$2,593	+5%	BCBS	UHC	120
22	New Hampshire	$2,574	+4%	Cigna	Aetna	118
23	Colorado	$2,482	+0%	UHC	Aetna	104
24	Maryland	$2,470	-0%	UHC	BCBS	105
25	Alabama	$2,425	-2%	BCBS	Cigna	118
26	Montana	$2,421	-2%	UHC	Cigna	79
27	Arkansas	$2,420	-2%	Cigna	Aetna	118
28	Utah	$2,416	-2%	UHC	Cigna	96
29	New York	$2,355	-5%	Cigna	Aetna	110
30	Kansas	$2,338	-5%	Cigna	Aetna	107
31	Pennsylvania	$2,313	-6%	UHC	Aetna	101
32	New Mexico	$2,282	-8%	UHC	Aetna	104
33	West Virginia	$2,266	-8%	UHC	BCBS	86
34	South Carolina	$2,247	-9%	UHC	Aetna	106
35	Arizona	$2,247	-9%	UHC	Aetna	99
36	Delaware	$2,246	-9%	Cigna	UHC	59
37	Virginia	$2,245	-9%	UHC	BCBS	105
38	Ohio	$2,173	-12%	UHC	Aetna	110
39	Kentucky	$2,153	-13%	Cigna	Aetna	124
40	Louisiana	$2,147	-13%	BCBS	Aetna	103
41	Maine	$2,146	-13%	UHC	Aetna	93
42	Nevada	$2,131	-14%	BCBS	Aetna	109
43	Missouri	$2,114	-14%	UHC	Aetna	112
44	Michigan	$2,051	-17%	BCBS	UHC	102
45	Indiana	$2,032	-18%	UHC	Aetna	115
46	Florida	$1,981	-20%	BCBS	Aetna	108
47	Minnesota	$1,909	-23%	UHC	Aetna	98
48	Hawaii	$1,856	-25%	BCBS	UHC	68
49	Texas	$1,843	-25%	UHC	Aetna	121
50	Oklahoma	$1,836	-26%	UHC	Aetna	100
51	California	$1,810	-27%	Cigna	Aetna	107

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 22558?

In the files we analyzed, UnitedHealthcare, at a median of $2,718 across 4,263 sampled providers. Aetna is lowest at $2,036, 33% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 174% of the 2026 Medicare non-facility rate of $1,423.88.

Which state has the highest median for CPT 22558?

Alaska has the highest median at $6,915; California has the lowest at $1,810.

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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