CPT 66991 · professional fee

Xcapsl ctrc rmvl insj 1+ (CPT 66991): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 66991, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$840

P10 to P90: $612 to $1,648

vs Medicare

144%

non-facility rate $582.18

Payer spread

1.14×

UHC $875 vs Aetna $771

State spread

4.9×

AK $2,738 to FL $558

4,619 sampled providers6,380 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 66991 in the files analyzed, at $875, 14% above Aetna ($771), the lowest of the 4 payers shown.

The state spread is 4.9×: Alaska has the highest median at $2,738 and Florida the lowest at $558, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 144% of the Medicare non-facility rate ($582.18), which ranks 129th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $317) and widest within UnitedHealthcare ($545).

This is a top-22 code for ophthalmology 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	$875	$706	$1,252	+4%	1	3,831	150% of Medicare
Cigna	$859	$700	$1,151	+2%	2	3,714	148% of Medicare
Blue Cross Blue Shield	$845	$666	$1,158	+1%	3	3,455	145% of Medicare
Aetna	$771	$703	$1,020	-8%	4	2,742	132% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($582.18)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$2,738	+226%	n/a	n/a	24
2	Nebraska	$1,544	+84%	Cigna	BCBS	70
3	South Dakota	$1,486	+77%	Cigna	UHC	39
4	Oregon	$1,379	+64%	UHC	Aetna	100
5	Wisconsin	$1,341	+60%	UHC	Aetna	84
6	North Dakota	$1,292	+54%	BCBS	Aetna	33
7	Connecticut	$1,275	+52%	UHC	Aetna	109
8	Iowa	$1,215	+45%	UHC	BCBS	92
9	Massachusetts	$1,124	+34%	Cigna	Aetna	115
10	Georgia	$1,096	+30%	Cigna	Aetna	114
11	Alabama	$1,080	+29%	Aetna	UHC	109
12	Idaho	$1,076	+28%	Aetna	UHC	57
13	Minnesota	$1,074	+28%	BCBS	Aetna	94
14	Montana	$1,066	+27%	UHC	Cigna	36
15	Maine	$1,025	+22%	UHC	Aetna	64
16	Washington	$1,020	+21%	Aetna	Cigna	119
17	Illinois	$997	+19%	BCBS	Aetna	111
18	Vermont	$987	+18%	Cigna	BCBS	33
19	New Hampshire	$945	+13%	UHC	Aetna	55
20	New Mexico	$928	+10%	UHC	BCBS	73
21	Colorado	$923	+10%	BCBS	Aetna	104
22	North Carolina	$902	+7%	BCBS	Aetna	117
23	West Virginia	$886	+5%	UHC	BCBS	76
24	Utah	$882	+5%	Cigna	UHC	114
25	Michigan	$879	+5%	Aetna	BCBS	109
26	Mississippi	$878	+4%	Aetna	UHC	103
27	Hawaii	$871	+4%	Cigna	UHC	85
28	South Carolina	$839	-0%	BCBS	UHC	101
29	Kansas	$837	-0%	BCBS	Cigna	106
30	Rhode Island	$808	-4%	Cigna	UHC	62
31	Tennessee	$800	-5%	BCBS	Cigna	120
32	Louisiana	$789	-6%	Aetna	UHC	109
33	Arkansas	$767	-9%	Cigna	Aetna	91
34	Oklahoma	$764	-9%	BCBS	UHC	111
35	New York	$751	-11%	Aetna	BCBS	109
36	Ohio	$748	-11%	UHC	BCBS	109
36	Missouri	$748	-11%	UHC	Cigna	110
38	Texas	$744	-11%	BCBS	Cigna	123
39	District of Columbia	$736	-12%	Aetna	BCBS	52
40	California	$736	-12%	Cigna	Aetna	121
41	Maryland	$717	-15%	Aetna	BCBS	105
41	Virginia	$717	-15%	Aetna	Cigna	107
43	Pennsylvania	$716	-15%	UHC	Aetna	116
44	Delaware	$712	-15%	Aetna	Cigna	47
45	Arizona	$709	-16%	UHC	BCBS	108
46	Kentucky	$699	-17%	Cigna	BCBS	112
47	Nevada	$697	-17%	BCBS	Aetna	111
48	New Jersey	$676	-20%	Aetna	Cigna	117
49	Indiana	$675	-20%	UHC	BCBS	115
50	Florida	$558	-34%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 66991?

In the files we analyzed, UnitedHealthcare, at a median of $875 across 3,831 sampled providers. Aetna is lowest at $771, 14% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 144% of the 2026 Medicare non-facility rate of $582.18.

Which state has the highest median for CPT 66991?

Alaska has the highest median at $2,738; Florida has the lowest at $558.

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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