CPT 52649 · professional fee

Prostate laser enucleation (CPT 52649): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 52649, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$1,355

P10 to P90: $848 to $2,446

vs Medicare

206%

non-facility rate $657.00

Payer spread

1.42×

UHC $1,505 vs Aetna $1,058

State spread

3.3×

AK $3,326 to DE $1,001

4,197 sampled providers4,813 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 52649 in the files analyzed, at $1,505, 42% above Aetna ($1,058), the lowest of the 4 payers shown.

The state spread is 3.3×: Alaska has the highest median at $3,326 and Delaware the lowest at $1,001, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 206% of the Medicare non-facility rate ($657.00), which ranks 28th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within UnitedHealthcare (interquartile range $771) and widest within Aetna ($635).

This is a top-26 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	$1,505	$1,165	$1,937	+11%	1	3,576	229% of Medicare
Cigna	$1,391	$1,120	$1,862	+3%	2	3,388	212% of Medicare
Blue Cross Blue Shield	$1,317	$1,038	$1,769	-3%	3	3,355	200% of Medicare
Aetna	$1,058	$843	$1,477	-22%	4	1,839	161% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($657.00)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$3,326	+145%	n/a	n/a	22
2	Oregon	$2,176	+61%	Aetna	BCBS	102
3	Wisconsin	$1,991	+47%	UHC	Aetna	102
4	Connecticut	$1,787	+32%	Cigna	BCBS	116
5	District of Columbia	$1,772	+31%	Cigna	BCBS	48
6	North Carolina	$1,740	+28%	BCBS	Aetna	122
7	Washington	$1,718	+27%	UHC	Aetna	111
8	New Hampshire	$1,700	+25%	UHC	Aetna	51
9	Mississippi	$1,661	+23%	Aetna	UHC	66
10	Alabama	$1,612	+19%	Aetna	Cigna	116
11	Nebraska	$1,607	+19%	Cigna	BCBS	50
12	South Dakota	$1,607	+19%	Cigna	BCBS	33
13	Iowa	$1,545	+14%	UHC	BCBS	83
14	Minnesota	$1,542	+14%	UHC	Aetna	111
15	Massachusetts	$1,533	+13%	UHC	Aetna	112
16	New Jersey	$1,520	+12%	Cigna	Aetna	104
17	North Dakota	$1,509	+11%	n/a	n/a	20
18	Georgia	$1,480	+9%	UHC	Aetna	118
19	Ohio	$1,453	+7%	UHC	Cigna	111
20	California	$1,449	+7%	UHC	Aetna	95
21	Colorado	$1,368	+1%	UHC	Aetna	113
22	Vermont	$1,367	+1%	UHC	BCBS	30
23	Utah	$1,362	+0%	Aetna	BCBS	73
24	Virginia	$1,332	-2%	UHC	BCBS	105
25	Rhode Island	$1,330	-2%	UHC	BCBS	40
26	Illinois	$1,317	-3%	UHC	Aetna	106
27	Idaho	$1,313	-3%	Aetna	UHC	45
28	South Carolina	$1,296	-4%	BCBS	Aetna	99
29	Montana	$1,296	-4%	UHC	Cigna	39
30	Kentucky	$1,290	-5%	Cigna	Aetna	116
31	Indiana	$1,288	-5%	BCBS	Aetna	124
32	West Virginia	$1,283	-5%	Cigna	BCBS	48
33	Tennessee	$1,281	-5%	UHC	Aetna	106
34	Maryland	$1,277	-6%	UHC	BCBS	102
35	Nevada	$1,264	-7%	UHC	BCBS	54
36	Missouri	$1,258	-7%	UHC	Aetna	118
37	Arkansas	$1,250	-8%	UHC	Aetna	65
38	New Mexico	$1,237	-9%	UHC	BCBS	33
39	Louisiana	$1,223	-10%	Aetna	Cigna	102
40	Pennsylvania	$1,220	-10%	UHC	Aetna	109
41	Kansas	$1,177	-13%	BCBS	Aetna	93
42	Maine	$1,172	-14%	UHC	Aetna	48
43	Texas	$1,167	-14%	UHC	BCBS	124
44	Florida	$1,149	-15%	BCBS	Aetna	112
45	Oklahoma	$1,112	-18%	UHC	Aetna	108
46	New York	$1,109	-18%	Cigna	BCBS	115
47	Arizona	$1,073	-21%	UHC	Aetna	99
48	Michigan	$1,047	-23%	UHC	BCBS	110
49	Hawaii	$1,022	-25%	Cigna	UHC	27
50	Delaware	$1,001	-26%	UHC	Cigna	29

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 52649?

In the files we analyzed, UnitedHealthcare, at a median of $1,505 across 3,576 sampled providers. Aetna is lowest at $1,058, 42% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 206% of the 2026 Medicare non-facility rate of $657.00.

Which state has the highest median for CPT 52649?

Alaska has the highest median at $3,326; Delaware has the lowest at $1,001.

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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