CPT 45390 · professional fee

Colonoscopy w/resection (CPT 45390): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 45390, from their published in-network rate files.

GastroenterologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$532

P10 to P90: $331 to $1,020

vs Medicare

183%

non-facility rate $290.25

Payer spread

1.29×

UHC $608 vs Aetna $470

State spread

3.3×

AK $1,322 to HI $402

4,403 sampled providers4,987 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 45390 in the files analyzed, at $608, 29% above Aetna ($470), the lowest of the 4 payers shown.

The state spread is 3.3×: Alaska has the highest median at $1,322 and Hawaii the lowest at $402, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 183% of the Medicare non-facility rate ($290.25), which ranks 61st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $229) and widest within Blue Cross Blue Shield ($349).

This is a top-24 code for gastroenterology 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	$608	$472	$805	+14%	1	3,757	210% of Medicare
Cigna	$566	$449	$760	+7%	2	2,949	195% of Medicare
Blue Cross Blue Shield	$487	$375	$724	-8%	3	3,523	168% of Medicare
Aetna	$470	$365	$595	-12%	4	2,767	162% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($290.25)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$1,322	+149%	n/a	n/a	16
2	Wisconsin	$1,085	+104%	BCBS	Aetna	107
3	Oregon	$959	+80%	UHC	Aetna	104
4	Connecticut	$851	+60%	UHC	Aetna	119
5	New Hampshire	$763	+44%	BCBS	Aetna	73
6	Minnesota	$750	+41%	UHC	Aetna	91
7	Nebraska	$737	+39%	UHC	BCBS	46
8	Mississippi	$714	+34%	BCBS	Cigna	92
9	Georgia	$711	+34%	Cigna	UHC	124
10	Washington	$701	+32%	UHC	Aetna	96
11	South Dakota	$667	+25%	BCBS	UHC	25
12	Massachusetts	$643	+21%	UHC	Aetna	113
13	Iowa	$641	+21%	Cigna	BCBS	55
14	North Dakota	$631	+19%	BCBS	UHC	20
15	Idaho	$623	+17%	Aetna	Cigna	52
16	North Carolina	$611	+15%	UHC	Aetna	124
17	Utah	$586	+10%	Aetna	BCBS	85
18	New Mexico	$566	+7%	UHC	BCBS	57
19	Tennessee	$563	+6%	UHC	Aetna	108
20	New Jersey	$563	+6%	UHC	Aetna	116
21	Vermont	$546	+3%	UHC	BCBS	23
22	Louisiana	$532	-0%	UHC	BCBS	121
23	Arkansas	$528	-1%	Cigna	Aetna	81
24	Colorado	$520	-2%	UHC	Aetna	124
25	California	$520	-2%	Cigna	BCBS	108
26	Montana	$515	-3%	UHC	Cigna	28
27	South Carolina	$513	-3%	BCBS	Aetna	113
28	District of Columbia	$506	-5%	Cigna	BCBS	51
29	Illinois	$496	-7%	UHC	Aetna	115
30	West Virginia	$496	-7%	UHC	BCBS	49
31	Kentucky	$495	-7%	UHC	BCBS	124
32	Missouri	$491	-8%	UHC	Aetna	134
33	Maine	$486	-9%	UHC	Aetna	53
34	Florida	$486	-9%	UHC	Cigna	117
35	Kansas	$482	-9%	Cigna	BCBS	62
36	Arizona	$475	-11%	UHC	BCBS	96
37	Ohio	$472	-11%	UHC	BCBS	123
37	Rhode Island	$472	-11%	UHC	BCBS	65
37	Pennsylvania	$472	-11%	UHC	BCBS	112
40	Virginia	$467	-12%	Cigna	BCBS	117
41	New York	$456	-14%	Cigna	BCBS	131
42	Michigan	$449	-16%	UHC	Aetna	110
43	Indiana	$448	-16%	UHC	Aetna	109
44	Oklahoma	$432	-19%	UHC	Aetna	97
45	Alabama	$418	-21%	Cigna	BCBS	111
46	Maryland	$417	-22%	Cigna	BCBS	110
47	Nevada	$412	-22%	BCBS	Aetna	84
48	Texas	$408	-23%	UHC	BCBS	132
49	Delaware	$407	-23%	UHC	Aetna	27
50	Hawaii	$402	-24%	UHC	Cigna	45

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 45390?

In the files we analyzed, UnitedHealthcare, at a median of $608 across 3,757 sampled providers. Aetna is lowest at $470, 29% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 183% of the 2026 Medicare non-facility rate of $290.25.

Which state has the highest median for CPT 45390?

Alaska has the highest median at $1,322; Hawaii has the lowest at $402.

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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