CPT 52310 · professional fee

Cystoscopy and treatment (CPT 52310): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 52310, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$317

P10 to P90: $184 to $633

vs Medicare

236%

facility rate $134.61

Payer spread

2.08×

UHC $480 vs Aetna $231

State spread

2.9×

AK $636 to MI $222

4,222 sampled providers4,861 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 52310 in the files analyzed, at $480, 108% above Aetna ($231), the lowest of the 4 payers shown.

The state spread is 2.9×: Alaska has the highest median at $636 and Michigan the lowest at $222, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 236% of the Medicare facility rate ($134.61), which ranks 20th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $113) and widest within UnitedHealthcare ($298).

This is a top-16 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 ($298.60) is 2.2× 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	$480	$359	$657	+51%	1	3,557	356% of Medicare
Blue Cross Blue Shield	$309	$236	$416	-3%	2	3,334	230% of Medicare
Cigna	$296	$232	$400	-7%	3	3,367	220% of Medicare
Aetna	$231	$186	$299	-27%	4	2,871	171% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($134.61)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$636	+100%	n/a	n/a	22
2	Wisconsin	$495	+56%	UHC	Aetna	103
3	North Carolina	$438	+38%	UHC	Aetna	123
4	Oregon	$417	+31%	UHC	Aetna	104
5	Washington	$410	+29%	UHC	Aetna	111
6	Mississippi	$398	+25%	BCBS	Cigna	67
7	Hawaii	$395	+24%	Cigna	UHC	28
8	Minnesota	$390	+23%	UHC	Aetna	112
9	North Dakota	$389	+23%	n/a	n/a	20
10	Georgia	$387	+22%	UHC	Aetna	118
11	District of Columbia	$385	+21%	UHC	BCBS	48
12	Connecticut	$379	+19%	UHC	Aetna	116
13	Vermont	$368	+16%	UHC	BCBS	30
14	Nebraska	$368	+16%	Cigna	BCBS	50
15	New Hampshire	$365	+15%	UHC	Aetna	51
16	Iowa	$355	+12%	UHC	Aetna	83
17	Massachusetts	$350	+10%	UHC	Aetna	112
18	Kansas	$337	+6%	BCBS	Aetna	93
19	New Jersey	$336	+6%	UHC	Aetna	106
20	Missouri	$333	+5%	UHC	Aetna	119
21	South Dakota	$329	+4%	UHC	BCBS	33
22	Pennsylvania	$327	+3%	UHC	Cigna	109
23	South Carolina	$317	-0%	BCBS	Aetna	100
24	Ohio	$316	-1%	UHC	Aetna	110
25	New York	$314	-1%	UHC	Aetna	114
26	Maryland	$313	-1%	UHC	BCBS	103
27	Utah	$312	-2%	UHC	Cigna	76
28	Illinois	$306	-4%	UHC	Aetna	107
29	Colorado	$302	-5%	UHC	Aetna	114
30	Virginia	$300	-6%	UHC	Aetna	104
31	Kentucky	$299	-6%	UHC	Aetna	115
32	Rhode Island	$297	-7%	UHC	Aetna	41
33	California	$292	-8%	UHC	Aetna	95
34	Nevada	$290	-9%	UHC	Cigna	57
35	West Virginia	$290	-9%	UHC	Aetna	49
36	Tennessee	$287	-10%	UHC	Aetna	108
37	Maine	$286	-10%	UHC	Aetna	48
38	Alabama	$284	-11%	UHC	Cigna	117
39	Arkansas	$282	-11%	UHC	Aetna	67
40	Idaho	$277	-13%	UHC	BCBS	45
41	Arizona	$276	-13%	UHC	BCBS	99
42	New Mexico	$266	-16%	UHC	Aetna	33
43	Florida	$265	-16%	UHC	Aetna	112
44	Louisiana	$264	-17%	UHC	BCBS	103
45	Delaware	$264	-17%	UHC	Aetna	29
46	Texas	$256	-19%	UHC	Aetna	124
47	Oklahoma	$241	-24%	UHC	Aetna	108
48	Indiana	$238	-25%	UHC	Aetna	124
49	Montana	$236	-26%	UHC	Cigna	39
50	Michigan	$222	-30%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 52310?

In the files we analyzed, UnitedHealthcare, at a median of $480 across 3,557 sampled providers. Aetna is lowest at $231, 108% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 236% of the 2026 Medicare facility rate of $134.61.

Which state has the highest median for CPT 52310?

Alaska has the highest median at $636; Michigan has the lowest at $222.

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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