CPT 52224 · professional fee

Cystoscopy and treatment (CPT 52224): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 52224, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$459

P10 to P90: $228 to $1,228

vs Medicare

261%

facility rate $175.69

Payer spread

3.25×

UHC $966 vs Aetna $297

State spread

3.6×

HI $995 to MD $273

4,192 sampled providers4,783 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 52224 in the files analyzed, at $966, 225% above Aetna ($297), the lowest of the 4 payers shown.

The state spread is 3.6×: Hawaii has the highest median at $995 and Maryland the lowest at $273, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 261% of the Medicare facility rate ($175.69), which ranks 10th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $162) and widest within UnitedHealthcare ($623).

This is a top-28 code for urology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

The Medicare comparison uses the facility rate: the non-facility rate ($760.20) is 4.3× 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	$966	$667	$1,290	+111%	1	3,452	550% of Medicare
Blue Cross Blue Shield	$413	$305	$540	-10%	2	3,257	235% of Medicare
Cigna	$379	$291	$532	-17%	3	3,211	216% of Medicare
Aetna	$297	$233	$395	-35%	4	2,282	169% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($175.69)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Hawaii	$995	+117%	UHC	Cigna	28
2	Alaska	$891	+94%	n/a	n/a	22
3	Wisconsin	$800	+74%	BCBS	Aetna	103
4	New York	$698	+52%	UHC	Aetna	113
5	New Hampshire	$563	+23%	UHC	Aetna	50
6	North Carolina	$559	+22%	UHC	Aetna	123
7	Georgia	$542	+18%	Cigna	Aetna	118
8	Oregon	$538	+17%	UHC	Aetna	100
9	Washington	$532	+16%	UHC	Aetna	111
10	Kansas	$520	+13%	UHC	Aetna	93
11	District of Columbia	$507	+11%	Cigna	BCBS	47
12	North Dakota	$505	+10%	n/a	n/a	20
13	Minnesota	$501	+9%	UHC	Aetna	111
14	Vermont	$488	+6%	UHC	Cigna	29
15	South Dakota	$479	+4%	UHC	BCBS	33
16	Indiana	$477	+4%	UHC	Aetna	124
17	Nebraska	$477	+4%	Cigna	BCBS	50
18	Pennsylvania	$477	+4%	UHC	Cigna	107
19	Connecticut	$474	+3%	UHC	Aetna	116
20	Massachusetts	$467	+2%	UHC	Aetna	112
21	Iowa	$461	+0%	UHC	Aetna	83
22	Arkansas	$457	-1%	UHC	Aetna	65
23	West Virginia	$451	-2%	UHC	Aetna	48
24	Kentucky	$447	-3%	UHC	Aetna	115
25	New Jersey	$445	-3%	Cigna	Aetna	106
26	California	$440	-4%	UHC	Aetna	93
27	Utah	$430	-6%	UHC	Cigna	73
28	South Carolina	$427	-7%	UHC	Aetna	100
29	Louisiana	$421	-8%	UHC	BCBS	102
30	Illinois	$419	-9%	UHC	Aetna	106
30	Missouri	$419	-9%	UHC	Aetna	118
32	Tennessee	$411	-11%	UHC	Aetna	106
33	Colorado	$408	-11%	UHC	Aetna	113
34	Florida	$407	-11%	UHC	Aetna	111
35	Arizona	$403	-12%	UHC	Aetna	99
36	Ohio	$398	-13%	UHC	BCBS	109
37	Rhode Island	$397	-13%	UHC	Aetna	41
38	Alabama	$395	-14%	UHC	BCBS	116
39	Mississippi	$395	-14%	UHC	Cigna	66
40	Idaho	$388	-16%	UHC	BCBS	45
41	Maine	$379	-17%	UHC	Aetna	48
42	Virginia	$378	-18%	UHC	BCBS	104
43	New Mexico	$371	-19%	UHC	Cigna	33
44	Texas	$355	-23%	UHC	Aetna	124
45	Delaware	$355	-23%	UHC	Aetna	29
46	Nevada	$349	-24%	UHC	Cigna	57
47	Oklahoma	$329	-28%	UHC	Aetna	108
48	Montana	$313	-32%	UHC	Cigna	39
49	Michigan	$290	-37%	UHC	Aetna	111
50	Maryland	$273	-40%	UHC	BCBS	102

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 52224?

In the files we analyzed, UnitedHealthcare, at a median of $966 across 3,452 sampled providers. Aetna is lowest at $297, 225% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 261% of the 2026 Medicare facility rate of $175.69.

Which state has the highest median for CPT 52224?

Hawaii has the highest median at $995; Maryland has the lowest at $273.

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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