CPT 46221 · professional fee

Ligation of hemorrhoid(s) (CPT 46221): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 46221, from their published in-network rate files.

GastroenterologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$346

P10 to P90: $206 to $686

vs Medicare

106%

non-facility rate $325.66

Payer spread

1.66×

UHC $470 vs Aetna $283

State spread

4.3×

AK $1,018 to DE $236

4,438 sampled providers5,118 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 46221 in the files analyzed, at $470, 66% above Aetna ($283), the lowest of the 4 payers shown.

The state spread is 4.3×: Alaska has the highest median at $1,018 and Delaware the lowest at $236, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 106% of the Medicare non-facility rate ($325.66), which ranks 186th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $147) and widest within Blue Cross Blue Shield ($229).

This is a top-27 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	$470	$345	$653	+36%	1	3,766	144% of Medicare
Cigna	$338	$274	$454	-2%	2	3,603	104% of Medicare
Blue Cross Blue Shield	$321	$241	$470	-7%	3	3,520	99% of Medicare
Aetna	$283	$220	$367	-18%	4	2,825	87% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($325.66)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$1,018	+194%	n/a	n/a	16
2	Oregon	$779	+125%	BCBS	Aetna	104
3	Wisconsin	$694	+101%	UHC	Aetna	110
4	Nebraska	$606	+75%	UHC	BCBS	46
5	Connecticut	$598	+73%	UHC	Aetna	122
6	Minnesota	$527	+52%	UHC	Aetna	91
7	South Dakota	$503	+45%	UHC	BCBS	25
8	New Hampshire	$488	+41%	UHC	Aetna	74
9	North Dakota	$486	+40%	UHC	BCBS	20
10	Iowa	$484	+40%	UHC	Aetna	55
11	Washington	$467	+35%	UHC	Aetna	96
12	Massachusetts	$442	+28%	UHC	Aetna	113
13	Georgia	$424	+22%	BCBS	Aetna	126
14	Idaho	$397	+15%	Aetna	Cigna	52
15	District of Columbia	$396	+14%	UHC	BCBS	51
16	New Jersey	$388	+12%	UHC	Aetna	116
17	Hawaii	$378	+9%	UHC	Cigna	45
18	Tennessee	$370	+7%	UHC	Aetna	109
19	Illinois	$364	+5%	UHC	Aetna	115
20	Utah	$354	+2%	UHC	Cigna	88
21	Missouri	$349	+1%	UHC	Aetna	135
22	Maine	$348	+0%	UHC	BCBS	53
23	New Mexico	$344	-1%	UHC	BCBS	58
24	Louisiana	$343	-1%	UHC	BCBS	121
25	New York	$341	-2%	UHC	Aetna	131
26	Vermont	$338	-2%	UHC	BCBS	22
27	Colorado	$338	-2%	UHC	Aetna	126
28	North Carolina	$332	-4%	UHC	Aetna	124
29	Arkansas	$329	-5%	UHC	Aetna	81
30	Mississippi	$323	-7%	Aetna	BCBS	92
31	Kansas	$323	-7%	UHC	BCBS	62
32	Pennsylvania	$322	-7%	UHC	Cigna	114
33	Rhode Island	$319	-8%	UHC	Aetna	66
33	Maryland	$319	-8%	UHC	BCBS	110
35	Arizona	$318	-8%	UHC	BCBS	98
36	Ohio	$317	-8%	UHC	BCBS	123
37	Virginia	$308	-11%	UHC	BCBS	118
38	Montana	$305	-12%	UHC	Cigna	28
39	Oklahoma	$304	-12%	UHC	Aetna	98
40	Kentucky	$302	-13%	UHC	BCBS	124
41	Florida	$298	-14%	UHC	Aetna	117
42	South Carolina	$295	-15%	UHC	Aetna	116
43	Texas	$292	-16%	UHC	Aetna	132
44	California	$284	-18%	UHC	BCBS	108
45	West Virginia	$283	-18%	UHC	BCBS	49
46	Indiana	$276	-20%	UHC	Aetna	110
47	Alabama	$269	-22%	Aetna	BCBS	115
48	Michigan	$256	-26%	UHC	BCBS	112
49	Nevada	$248	-28%	UHC	Aetna	84
50	Delaware	$236	-32%	UHC	Aetna	29

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 46221?

In the files we analyzed, UnitedHealthcare, at a median of $470 across 3,766 sampled providers. Aetna is lowest at $283, 66% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 106% of the 2026 Medicare non-facility rate of $325.66.

Which state has the highest median for CPT 46221?

Alaska has the highest median at $1,018; Delaware has the lowest at $236.

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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