CPT 55866 · professional fee

Laps surg prst8ect rpbic rad (CPT 55866): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 55866, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$2,237

P10 to P90: $1,380 to $4,011

vs Medicare

207%

non-facility rate $1,081.86

Payer spread

1.37×

UHC $2,552 vs Aetna $1,859

State spread

3.6×

AK $5,308 to HI $1,461

4,227 sampled providers4,856 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 55866 in the files analyzed, at $2,552, 37% above Aetna ($1,859), the lowest of the 4 payers shown.

The state spread is 3.6×: Alaska has the highest median at $5,308 and Hawaii the lowest at $1,461, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 207% of the Medicare non-facility rate ($1,081.86), which ranks 26th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $916) and widest within Blue Cross Blue Shield ($1,217).

This is a top-15 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	$2,552	$2,005	$3,325	+14%	1	3,575	236% of Medicare
Cigna	$2,376	$1,852	$3,039	+6%	2	3,391	220% of Medicare
Blue Cross Blue Shield	$2,163	$1,672	$2,888	-3%	3	3,380	200% of Medicare
Aetna	$1,859	$1,445	$2,361	-17%	4	2,531	172% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($1,081.86)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$5,308	+137%	n/a	n/a	22
2	Wisconsin	$3,943	+76%	UHC	Aetna	113
3	Oregon	$3,226	+44%	UHC	Aetna	103
4	District of Columbia	$3,029	+35%	Cigna	BCBS	48
5	Mississippi	$2,868	+28%	BCBS	UHC	67
6	North Carolina	$2,848	+27%	UHC	Aetna	123
7	New Hampshire	$2,716	+21%	UHC	BCBS	51
8	Connecticut	$2,690	+20%	BCBS	Aetna	116
9	New Jersey	$2,639	+18%	BCBS	Aetna	106
10	South Dakota	$2,603	+16%	Cigna	BCBS	33
11	Iowa	$2,544	+14%	UHC	Aetna	83
12	Georgia	$2,539	+13%	UHC	Aetna	118
13	Washington	$2,522	+13%	Aetna	BCBS	111
14	Minnesota	$2,445	+9%	UHC	Aetna	111
15	North Dakota	$2,421	+8%	n/a	n/a	21
16	Utah	$2,403	+7%	Aetna	BCBS	74
17	Vermont	$2,387	+7%	UHC	BCBS	30
18	Nebraska	$2,379	+6%	Cigna	BCBS	50
19	Ohio	$2,375	+6%	UHC	Aetna	111
20	Idaho	$2,293	+2%	Aetna	BCBS	45
21	Rhode Island	$2,291	+2%	UHC	BCBS	40
22	New Mexico	$2,261	+1%	UHC	BCBS	33
23	California	$2,252	+1%	Cigna	Aetna	95
24	Massachusetts	$2,236	-0%	UHC	Aetna	112
25	Colorado	$2,227	-0%	UHC	Aetna	114
26	Kansas	$2,211	-1%	UHC	Aetna	93
27	Arkansas	$2,199	-2%	Cigna	Aetna	65
28	South Carolina	$2,194	-2%	BCBS	Aetna	100
29	Maryland	$2,186	-2%	UHC	BCBS	103
30	Kentucky	$2,182	-2%	Cigna	Aetna	116
31	Nevada	$2,133	-5%	UHC	BCBS	57
32	Indiana	$2,122	-5%	Cigna	Aetna	124
32	Illinois	$2,122	-5%	UHC	Aetna	106
34	Virginia	$2,103	-6%	UHC	BCBS	105
35	Tennessee	$2,100	-6%	UHC	BCBS	106
36	Alabama	$2,066	-8%	BCBS	Cigna	117
37	Pennsylvania	$2,060	-8%	Aetna	Cigna	109
38	Missouri	$2,045	-9%	UHC	Aetna	119
39	New York	$2,027	-9%	Cigna	BCBS	115
40	Louisiana	$2,018	-10%	UHC	Cigna	104
41	Florida	$2,015	-10%	BCBS	Aetna	112
42	Maine	$1,984	-11%	UHC	Aetna	48
43	Montana	$1,868	-17%	UHC	BCBS	39
44	West Virginia	$1,865	-17%	Cigna	Aetna	49
45	Oklahoma	$1,842	-18%	UHC	Cigna	108
46	Arizona	$1,820	-19%	UHC	BCBS	99
47	Texas	$1,792	-20%	UHC	BCBS	124
48	Michigan	$1,788	-20%	UHC	Aetna	111
49	Delaware	$1,736	-22%	UHC	Aetna	29
50	Hawaii	$1,461	-35%	UHC	Cigna	27

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 55866?

In the files we analyzed, UnitedHealthcare, at a median of $2,552 across 3,575 sampled providers. Aetna is lowest at $1,859, 37% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 207% of the 2026 Medicare non-facility rate of $1,081.86.

Which state has the highest median for CPT 55866?

Alaska has the highest median at $5,308; Hawaii has the lowest at $1,461.

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.

See how your contracts compare for CPT 55866

Benchmark your negotiated rates for 55866 and the rest of your book against these payer and state medians.

Request a rate benchmark