CPT 52281 · professional fee

Cystoscopy and treatment (CPT 52281): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 52281, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$334

P10 to P90: $184 to $679

vs Medicare

244%

facility rate $136.61

Payer spread

2.31×

UHC $531 vs Aetna $230

State spread

3.3×

AK $743 to MI $226

4,218 sampled providers4,839 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 52281 in the files analyzed, at $531, 131% above Aetna ($230), the lowest of the 4 payers shown.

The state spread is 3.3×: Alaska has the highest median at $743 and Michigan the lowest at $226, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 244% of the Medicare facility rate ($136.61), which ranks 19th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $116) and widest within Blue Cross Blue Shield ($198).

This is a top-32 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 ($310.29) is 2.3× 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	$531	$403	$704	+59%	1	3,556	389% of Medicare
Blue Cross Blue Shield	$321	$246	$443	-4%	2	3,345	235% of Medicare
Cigna	$304	$234	$417	-9%	3	3,358	222% of Medicare
Aetna	$230	$184	$300	-31%	4	2,633	168% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($136.61)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$743	+122%	n/a	n/a	22
2	Wisconsin	$540	+62%	UHC	Aetna	103
3	North Carolina	$482	+44%	UHC	Aetna	123
4	Washington	$441	+32%	UHC	Aetna	111
5	New Hampshire	$424	+27%	UHC	Aetna	51
6	Nebraska	$423	+27%	UHC	BCBS	50
7	Oregon	$419	+26%	UHC	Aetna	102
8	Mississippi	$419	+25%	BCBS	Cigna	67
9	Georgia	$415	+24%	UHC	Aetna	118
10	Vermont	$407	+22%	UHC	BCBS	30
11	Hawaii	$402	+20%	UHC	Cigna	28
12	Minnesota	$396	+19%	UHC	Aetna	112
13	North Dakota	$395	+18%	n/a	n/a	20
14	District of Columbia	$387	+16%	UHC	BCBS	48
15	Connecticut	$381	+14%	UHC	Aetna	116
16	Massachusetts	$367	+10%	UHC	Aetna	112
17	South Dakota	$356	+7%	UHC	BCBS	33
17	Iowa	$356	+7%	UHC	Aetna	83
19	Pennsylvania	$344	+3%	UHC	Cigna	109
20	Ohio	$343	+3%	UHC	Aetna	112
21	New Jersey	$338	+1%	UHC	Aetna	106
22	Kentucky	$338	+1%	UHC	Aetna	116
23	New York	$332	-1%	UHC	Aetna	114
24	West Virginia	$332	-1%	UHC	Aetna	49
25	Alabama	$323	-3%	UHC	Cigna	117
26	Illinois	$322	-3%	UHC	Aetna	106
26	Missouri	$322	-3%	UHC	Aetna	119
26	Maryland	$322	-3%	UHC	BCBS	103
29	Kansas	$319	-4%	UHC	Aetna	93
30	South Carolina	$318	-5%	UHC	Aetna	100
31	Utah	$318	-5%	UHC	Cigna	76
32	Indiana	$318	-5%	UHC	Aetna	124
33	Virginia	$317	-5%	UHC	Aetna	104
34	Rhode Island	$315	-6%	UHC	Aetna	40
35	California	$304	-9%	UHC	Aetna	95
36	Colorado	$304	-9%	UHC	Aetna	114
37	Arkansas	$294	-12%	UHC	Aetna	67
38	Nevada	$292	-13%	UHC	Cigna	57
39	Arizona	$291	-13%	UHC	BCBS	99
40	Tennessee	$290	-13%	UHC	Aetna	106
41	Idaho	$290	-13%	UHC	BCBS	45
42	Maine	$287	-14%	UHC	Aetna	48
43	Florida	$278	-17%	UHC	Aetna	112
44	New Mexico	$270	-19%	UHC	BCBS	33
45	Texas	$268	-20%	UHC	Aetna	124
46	Delaware	$265	-20%	UHC	Aetna	29
47	Louisiana	$265	-21%	UHC	BCBS	102
48	Oklahoma	$242	-28%	UHC	Aetna	108
49	Montana	$237	-29%	UHC	BCBS	39
50	Michigan	$226	-32%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 52281?

In the files we analyzed, UnitedHealthcare, at a median of $531 across 3,556 sampled providers. Aetna is lowest at $230, 131% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 244% of the 2026 Medicare facility rate of $136.61.

Which state has the highest median for CPT 52281?

Alaska has the highest median at $743; Michigan has the lowest at $226.

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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