CPT 67036 · professional fee

Removal of inner eye fluid (CPT 67036): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 67036, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$1,117

P10 to P90: $809 to $2,161

vs Medicare

147%

non-facility rate $759.20

Payer spread

1.15×

BCBS $1,213 vs Aetna $1,055

State spread

3.9×

AK $2,841 to FL $725

4,624 sampled providers6,417 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Blue Cross Blue Shield has the highest median for CPT 67036 in the files analyzed, at $1,213, 15% above Aetna ($1,055), the lowest of the 4 payers shown.

The state spread is 3.9×: Alaska has the highest median at $2,841 and Florida the lowest at $725, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 147% of the Medicare non-facility rate ($759.20), which ranks 119th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $451) and widest within UnitedHealthcare ($738).

This is a top-33 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
Blue Cross Blue Shield	$1,213	$942	$1,630	+9%	1	3,458	160% of Medicare
UnitedHealthcare	$1,127	$882	$1,620	+1%	2	3,834	148% of Medicare
Cigna	$1,117	$866	$1,560	+0%	3	3,783	147% of Medicare
Aetna	$1,055	$914	$1,366	-6%	4	2,725	139% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($759.20)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$2,841	+154%	n/a	n/a	23
2	Nebraska	$2,023	+81%	Cigna	BCBS	70
3	South Dakota	$1,931	+73%	Cigna	UHC	39
4	Oregon	$1,776	+59%	UHC	Aetna	100
5	Wisconsin	$1,753	+57%	UHC	Aetna	84
6	Alabama	$1,718	+54%	BCBS	UHC	111
7	North Dakota	$1,664	+49%	BCBS	Aetna	33
8	Iowa	$1,629	+46%	UHC	BCBS	93
9	Connecticut	$1,590	+42%	UHC	Aetna	109
10	Massachusetts	$1,538	+38%	Cigna	Aetna	116
11	Georgia	$1,485	+33%	Cigna	Aetna	113
12	Idaho	$1,410	+26%	Aetna	UHC	57
13	Montana	$1,398	+25%	UHC	Cigna	36
14	Minnesota	$1,377	+23%	BCBS	Aetna	94
15	Maine	$1,374	+23%	Aetna	UHC	64
16	Vermont	$1,345	+20%	Cigna	BCBS	33
17	Washington	$1,344	+20%	Aetna	Cigna	120
18	Illinois	$1,296	+16%	BCBS	Aetna	111
19	Mississippi	$1,283	+15%	Aetna	UHC	103
20	New Mexico	$1,274	+14%	UHC	BCBS	73
21	New Hampshire	$1,227	+10%	UHC	Aetna	55
22	Colorado	$1,205	+8%	BCBS	Aetna	103
23	Michigan	$1,194	+7%	BCBS	UHC	112
24	Hawaii	$1,137	+2%	UHC	Cigna	85
25	West Virginia	$1,137	+2%	Cigna	BCBS	76
26	Utah	$1,117	+0%	BCBS	UHC	115
27	Rhode Island	$1,085	-3%	Cigna	UHC	62
28	Kansas	$1,079	-3%	BCBS	Cigna	106
29	Arkansas	$1,076	-4%	Cigna	UHC	91
30	North Carolina	$1,062	-5%	Cigna	Aetna	118
31	Tennessee	$1,056	-5%	BCBS	Cigna	119
32	Louisiana	$1,031	-8%	Aetna	UHC	109
33	Indiana	$1,015	-9%	BCBS	Aetna	115
34	Missouri	$1,006	-10%	UHC	Cigna	110
35	Oklahoma	$998	-11%	BCBS	UHC	111
36	New York	$986	-12%	Aetna	Cigna	109
37	Texas	$982	-12%	Aetna	UHC	122
38	Maryland	$975	-13%	Aetna	BCBS	105
39	South Carolina	$964	-14%	Aetna	Cigna	102
40	Arizona	$960	-14%	BCBS	Cigna	108
41	Ohio	$959	-14%	UHC	Aetna	109
42	Kentucky	$954	-15%	Cigna	BCBS	112
43	District of Columbia	$941	-16%	Aetna	BCBS	52
44	Nevada	$941	-16%	BCBS	Aetna	111
45	Virginia	$941	-16%	Aetna	Cigna	106
46	California	$889	-20%	Cigna	Aetna	121
47	Pennsylvania	$889	-20%	UHC	Cigna	116
48	New Jersey	$887	-21%	Aetna	Cigna	117
49	Delaware	$833	-25%	Aetna	Cigna	47
50	Florida	$725	-35%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 67036?

In the files we analyzed, Blue Cross Blue Shield, at a median of $1,213 across 3,458 sampled providers. Aetna is lowest at $1,055, 15% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 147% of the 2026 Medicare non-facility rate of $759.20.

Which state has the highest median for CPT 67036?

Alaska has the highest median at $2,841; Florida has the lowest at $725.

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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