CPT 52356 · professional fee

Cysto/uretero w/lithotripsy (CPT 52356): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 52356, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$657

P10 to P90: $417 to $1,167

vs Medicare

180%

non-facility rate $365.07

Payer spread

1.39×

UHC $741 vs Aetna $532

State spread

3.5×

AK $1,652 to DE $470

4,227 sampled providers4,890 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 52356 in the files analyzed, at $741, 39% above Aetna ($532), the lowest of the 4 payers shown.

The state spread is 3.5×: Alaska has the highest median at $1,652 and Delaware the lowest at $470, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 180% of the Medicare non-facility rate ($365.07), which ranks 66th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Cigna (interquartile range $360) and widest within Aetna ($312).

This is a top-6 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
UnitedHealthcare	$741	$568	$971	+13%	1	3,576	203% of Medicare
Blue Cross Blue Shield	$686	$498	$893	+4%	2	3,386	188% of Medicare
Cigna	$664	$547	$907	+1%	3	3,383	182% of Medicare
Aetna	$532	$433	$745	-19%	4	2,831	146% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($365.07)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$1,652	+151%	n/a	n/a	22
2	Oregon	$1,070	+63%	UHC	Aetna	104
3	Wisconsin	$989	+50%	UHC	Aetna	103
4	District of Columbia	$893	+36%	Cigna	BCBS	48
5	South Dakota	$859	+31%	Cigna	UHC	33
6	Connecticut	$853	+30%	Cigna	BCBS	116
7	Washington	$846	+29%	UHC	BCBS	111
8	New Hampshire	$839	+28%	UHC	Aetna	51
9	Nebraska	$820	+25%	Cigna	BCBS	50
10	Iowa	$803	+22%	UHC	Aetna	83
11	Mississippi	$784	+19%	Aetna	UHC	66
12	Minnesota	$775	+18%	UHC	Aetna	112
13	New Jersey	$760	+16%	Cigna	Aetna	106
14	North Carolina	$747	+14%	UHC	Aetna	123
15	Illinois	$741	+13%	UHC	Aetna	106
16	Alabama	$739	+12%	BCBS	Cigna	117
17	North Dakota	$735	+12%	n/a	n/a	20
18	Georgia	$721	+10%	UHC	Cigna	118
19	Nevada	$701	+7%	Aetna	BCBS	57
20	Massachusetts	$694	+6%	UHC	Aetna	112
21	Ohio	$683	+4%	UHC	Aetna	112
22	Vermont	$670	+2%	UHC	BCBS	30
23	Maryland	$670	+2%	UHC	BCBS	103
24	Colorado	$667	+2%	UHC	Aetna	114
25	Utah	$652	-1%	UHC	Cigna	76
26	Idaho	$644	-2%	Aetna	BCBS	45
26	Montana	$644	-2%	UHC	BCBS	39
28	Missouri	$628	-4%	UHC	Aetna	119
29	South Carolina	$622	-5%	BCBS	Aetna	100
30	Tennessee	$618	-6%	Cigna	Aetna	108
31	New Mexico	$616	-6%	UHC	BCBS	33
32	Pennsylvania	$616	-6%	UHC	Aetna	111
33	New York	$615	-6%	Cigna	BCBS	115
34	Louisiana	$615	-6%	Aetna	BCBS	104
35	California	$607	-8%	UHC	Aetna	95
36	Michigan	$603	-8%	BCBS	Aetna	111
37	Virginia	$600	-9%	UHC	BCBS	105
38	Arkansas	$598	-9%	UHC	Aetna	66
39	West Virginia	$593	-10%	Cigna	Aetna	49
40	Maine	$593	-10%	UHC	Aetna	48
41	Kansas	$591	-10%	BCBS	Aetna	93
42	Kentucky	$576	-12%	UHC	BCBS	116
43	Texas	$570	-13%	UHC	BCBS	124
44	Florida	$565	-14%	BCBS	Aetna	112
45	Rhode Island	$556	-15%	UHC	BCBS	41
46	Oklahoma	$540	-18%	UHC	Aetna	108
47	Arizona	$525	-20%	UHC	Aetna	99
48	Hawaii	$501	-24%	UHC	Cigna	28
49	Indiana	$497	-24%	UHC	BCBS	124
50	Delaware	$470	-28%	UHC	Aetna	29

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 52356?

In the files we analyzed, UnitedHealthcare, at a median of $741 across 3,576 sampled providers. Aetna is lowest at $532, 39% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 180% of the 2026 Medicare non-facility rate of $365.07.

Which state has the highest median for CPT 52356?

Alaska has the highest median at $1,652; Delaware has the lowest at $470.

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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