CPT 51798 · professional fee

Us urine capacity measure (CPT 51798): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 51798, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$21

P10 to P90: $12 to $40

vs Medicare

168%

non-facility rate $12.69

Payer spread

1.63×

Cigna $31 vs Aetna $19

State spread

3.6×

AK $50 to OK $14

4,068 sampled providers4,179 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Cigna has the highest median for CPT 51798 in the files analyzed, at $31, 63% above Aetna ($19), the lowest of the 4 payers shown.

The state spread is 3.6×: Alaska has the highest median at $50 and Oklahoma the lowest at $14, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 168% of the Medicare non-facility rate ($12.69), which ranks 84th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within UnitedHealthcare (interquartile range $13) and widest within Cigna ($29).

This is a top-11 code for urology 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
Cigna	$31	$26	$55	+43%	1	470	241% of Medicare
Blue Cross Blue Shield	$22	$15	$30	+1%	2	3,118	170% of Medicare
UnitedHealthcare	$21	$16	$29	+0%	3	3,580	168% of Medicare
Aetna	$19	$13	$26	-12%	4	2,092	147% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($12.69)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$50	+135%	n/a	n/a	19
2	Wisconsin	$41	+91%	BCBS	UHC	109
3	Minnesota	$31	+45%	UHC	Aetna	84
4	Oregon	$29	+35%	UHC	Aetna	100
5	New Hampshire	$29	+34%	UHC	BCBS	50
5	South Dakota	$29	+34%	BCBS	UHC	33
7	Georgia	$27	+29%	Cigna	UHC	116
8	Mississippi	$27	+28%	BCBS	UHC	66
9	North Carolina	$27	+25%	BCBS	Aetna	105
10	California	$26	+21%	BCBS	Aetna	95
10	Massachusetts	$26	+21%	Aetna	BCBS	97
12	North Dakota	$26	+20%	n/a	n/a	20
13	Iowa	$25	+19%	UHC	BCBS	80
14	District of Columbia	$25	+18%	UHC	BCBS	47
15	Utah	$25	+16%	Aetna	BCBS	68
16	Washington	$24	+13%	Aetna	BCBS	99
17	Vermont	$24	+12%	UHC	BCBS	30
18	Maine	$23	+8%	Aetna	UHC	46
19	Nevada	$23	+8%	Aetna	UHC	55
20	Illinois	$23	+7%	BCBS	Aetna	106
21	New York	$23	+6%	Cigna	BCBS	116
22	Connecticut	$23	+6%	UHC	BCBS	110
22	Ohio	$23	+6%	BCBS	Aetna	111
24	Virginia	$22	+5%	Aetna	BCBS	101
25	South Carolina	$22	+3%	BCBS	UHC	94
26	Maryland	$21	+0%	UHC	BCBS	101
27	New Jersey	$21	-1%	BCBS	Aetna	104
28	Alabama	$21	-1%	Cigna	UHC	113
29	Missouri	$21	-2%	Cigna	Aetna	116
30	Nebraska	$21	-2%	UHC	BCBS	50
31	Kentucky	$21	-4%	Cigna	Aetna	115
32	Tennessee	$20	-4%	Cigna	Aetna	104
33	Pennsylvania	$20	-5%	BCBS	UHC	103
34	Kansas	$20	-6%	Cigna	Aetna	92
35	West Virginia	$20	-8%	UHC	BCBS	46
36	Louisiana	$19	-12%	UHC	Aetna	101
37	Colorado	$18	-16%	UHC	Aetna	114
38	Montana	$18	-16%	UHC	BCBS	39
39	Indiana	$18	-17%	Cigna	Aetna	122
40	Arkansas	$18	-18%	UHC	Aetna	65
41	Idaho	$18	-18%	UHC	BCBS	45
42	Florida	$17	-18%	BCBS	UHC	108
43	New Mexico	$17	-19%	UHC	BCBS	32
44	Delaware	$16	-24%	UHC	Aetna	29
45	Texas	$16	-25%	UHC	BCBS	123
46	Arizona	$16	-25%	UHC	Aetna	98
47	Hawaii	$16	-26%	Cigna	UHC	28
48	Rhode Island	$16	-27%	UHC	BCBS	39
49	Michigan	$15	-29%	UHC	Aetna	111
50	Oklahoma	$14	-35%	UHC	Aetna	104

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 51798?

In the files we analyzed, Cigna, at a median of $31 across 470 sampled providers. Aetna is lowest at $19, 63% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 168% of the 2026 Medicare non-facility rate of $12.69.

Which state has the highest median for CPT 51798?

Alaska has the highest median at $50; Oklahoma has the lowest at $14.

Is this a professional fee?

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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