CPT 37243 · professional fee

Vasc embolize/occlude organ (CPT 37243): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 37243, from their published in-network rate files.

Diagnostic radiologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$858

P10 to P90: $588 to $1,524

vs Medicare

178%

facility rate $482.31

Payer spread

1.34×

UHC $978 vs Aetna $727

State spread

1.8×

GA $1,154 to IN $646

5,682 sampled providers7,416 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 37243 in the files analyzed, at $978, 34% above Aetna ($727), the lowest of the 4 payers shown.

The state spread is 1.8×: Georgia has the highest median at $1,154 and Indiana the lowest at $646, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 178% of the Medicare facility rate ($482.31), which ranks 72nd of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Blue Cross Blue Shield (interquartile range $408) and widest within UnitedHealthcare ($663).

This is a top-40 code for diagnostic radiology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

The Medicare comparison uses the facility rate: the non-facility rate ($7,995.17) is 16.6× 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

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$978	$701	$1,364	+14%	1	3,707	203% of Medicare
Cigna	$869	$727	$1,149	+1%	2	4,387	180% of Medicare
Blue Cross Blue Shield	$855	$679	$1,087	-0%	3	4,363	177% of Medicare
Aetna	$727	$627	$1,018	-15%	4	3,109	151% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($482.31)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Georgia	$1,154	+34%	UHC	Aetna	128
2	South Dakota	$1,141	+33%	UHC	Aetna	85
3	Washington	$1,136	+32%	Cigna	Aetna	111
4	Wisconsin	$1,121	+31%	UHC	Aetna	112
5	North Carolina	$1,120	+31%	UHC	Aetna	123
6	Alaska	$1,093	+27%	UHC	Cigna	55
7	North Dakota	$1,055	+23%	BCBS	Aetna	83
8	New Hampshire	$1,045	+22%	UHC	Aetna	128
9	Wyoming	$1,033	+20%	BCBS	Cigna	40
10	Iowa	$1,006	+17%	Cigna	UHC	99
11	Connecticut	$999	+16%	BCBS	Cigna	124
12	Illinois	$991	+15%	UHC	Aetna	122
13	Ohio	$934	+9%	UHC	BCBS	126
14	Colorado	$928	+8%	UHC	Aetna	120
15	Oregon	$922	+7%	BCBS	Aetna	104
16	Massachusetts	$916	+7%	UHC	Aetna	119
17	Nebraska	$914	+7%	Cigna	Aetna	118
18	Arkansas	$910	+6%	UHC	Aetna	117
19	Idaho	$897	+5%	Aetna	UHC	124
20	Missouri	$897	+5%	UHC	Aetna	122
21	Tennessee	$882	+3%	BCBS	Aetna	130
22	Louisiana	$879	+2%	UHC	BCBS	119
23	Montana	$877	+2%	Aetna	Cigna	69
24	Maine	$869	+1%	UHC	Cigna	127
24	Vermont	$869	+1%	Cigna	Aetna	60
26	Virginia	$858	-0%	UHC	BCBS	119
27	Kansas	$855	-0%	UHC	Aetna	110
28	Utah	$835	-3%	UHC	Cigna	115
29	Minnesota	$823	-4%	UHC	Aetna	123
29	District of Columbia	$823	-4%	UHC	BCBS	133
29	Hawaii	$823	-4%	UHC	Aetna	81
32	New Mexico	$814	-5%	UHC	BCBS	123
33	Texas	$813	-5%	UHC	Aetna	132
33	South Carolina	$813	-5%	Cigna	Aetna	109
35	Alabama	$812	-5%	Aetna	UHC	125
36	Pennsylvania	$809	-6%	UHC	Aetna	119
37	Florida	$809	-6%	UHC	Aetna	108
38	Michigan	$789	-8%	Cigna	BCBS	116
39	New Jersey	$788	-8%	UHC	Aetna	126
40	West Virginia	$787	-8%	UHC	Aetna	117
41	Mississippi	$774	-10%	Aetna	UHC	110
42	Nevada	$757	-12%	UHC	Cigna	122
43	Arizona	$752	-12%	UHC	Aetna	108
44	New York	$746	-13%	BCBS	Aetna	116
45	Kentucky	$735	-14%	UHC	BCBS	133
46	Oklahoma	$730	-15%	Cigna	UHC	110
47	Rhode Island	$727	-15%	UHC	Cigna	125
48	California	$713	-17%	UHC	Aetna	102
49	Delaware	$702	-18%	UHC	BCBS	94
50	Maryland	$687	-20%	UHC	BCBS	107
51	Indiana	$646	-25%	Cigna	BCBS	134

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 37243?

In the files we analyzed, UnitedHealthcare, at a median of $978 across 3,707 sampled providers. Aetna is lowest at $727, 34% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 178% of the 2026 Medicare facility rate of $482.31.

Which state has the highest median for CPT 37243?

Georgia has the highest median at $1,154; Indiana has the lowest at $646.

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.

See how your contracts compare for CPT 37243

Benchmark your negotiated rates for 37243 and the rest of your book against these payer and state medians.

Request a rate benchmark