CPT 67210 · professional fee

Treatment of retinal lesion (CPT 67210): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 67210, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$659

P10 to P90: $474 to $1,278

vs Medicare

128%

non-facility rate $517.38

Payer spread

1.13×

BCBS $693 vs Aetna $616

State spread

4.8×

AK $1,999 to FL $415

4,634 sampled providers6,420 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 67210 in the files analyzed, at $693, 13% above Aetna ($616), the lowest of the 4 payers shown.

The state spread is 4.8×: Alaska has the highest median at $1,999 and Florida the lowest at $415, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 128% of the Medicare non-facility rate ($517.38), which ranks 156th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $238) and widest within UnitedHealthcare ($430).

This is a top-28 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	$693	$564	$998	+5%	1	3,485	134% of Medicare
UnitedHealthcare	$661	$529	$959	+0%	2	3,834	128% of Medicare
Cigna	$659	$517	$898	+0%	3	3,783	128% of Medicare
Aetna	$616	$520	$758	-7%	4	2,635	119% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($517.38)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$1,999	+203%	n/a	n/a	23
2	Nebraska	$1,159	+76%	Cigna	BCBS	70
3	Oregon	$1,115	+69%	UHC	Aetna	99
4	South Dakota	$1,093	+66%	Cigna	UHC	39
5	Wisconsin	$1,076	+63%	BCBS	Aetna	100
6	Iowa	$1,051	+59%	Cigna	Aetna	93
7	North Dakota	$983	+49%	BCBS	Aetna	33
8	Alabama	$954	+45%	BCBS	UHC	111
9	Connecticut	$949	+44%	UHC	Aetna	109
10	Mississippi	$890	+35%	BCBS	UHC	103
11	Georgia	$889	+35%	Cigna	Aetna	113
12	Massachusetts	$888	+35%	UHC	Aetna	115
13	Minnesota	$833	+26%	BCBS	Aetna	94
14	Idaho	$805	+22%	Aetna	UHC	57
15	Montana	$779	+18%	UHC	Cigna	36
16	New Mexico	$778	+18%	UHC	BCBS	71
17	Vermont	$771	+17%	Cigna	BCBS	33
18	Maine	$766	+16%	UHC	Cigna	64
19	Washington	$752	+14%	Aetna	Cigna	120
20	Colorado	$744	+13%	UHC	Aetna	103
20	New Hampshire	$744	+13%	UHC	Aetna	55
22	West Virginia	$739	+12%	UHC	Aetna	76
23	Rhode Island	$734	+11%	Cigna	BCBS	62
24	Illinois	$733	+11%	Cigna	Aetna	111
25	North Carolina	$706	+7%	BCBS	Aetna	118
26	Utah	$682	+3%	Cigna	UHC	115
27	Hawaii	$659	+0%	UHC	Cigna	85
28	Michigan	$641	-3%	UHC	BCBS	112
29	Kansas	$620	-6%	BCBS	Cigna	106
30	Tennessee	$618	-6%	BCBS	Cigna	119
31	California	$618	-6%	Cigna	UHC	121
32	South Carolina	$617	-6%	BCBS	UHC	101
33	Ohio	$616	-7%	BCBS	Aetna	108
34	Kentucky	$603	-9%	Cigna	Aetna	112
35	Louisiana	$591	-10%	Aetna	UHC	109
36	Arkansas	$590	-11%	Cigna	Aetna	91
37	Maryland	$587	-11%	Aetna	BCBS	105
38	New York	$582	-12%	Aetna	UHC	109
39	Missouri	$582	-12%	BCBS	Cigna	110
40	Texas	$563	-15%	UHC	BCBS	122
41	Oklahoma	$555	-16%	BCBS	UHC	111
42	Virginia	$540	-18%	Aetna	Cigna	106
43	Pennsylvania	$534	-19%	UHC	BCBS	116
44	District of Columbia	$530	-20%	Aetna	BCBS	52
45	Nevada	$526	-20%	BCBS	Aetna	111
46	Delaware	$523	-21%	UHC	Cigna	47
47	New Jersey	$519	-21%	Aetna	Cigna	117
48	Arizona	$517	-22%	UHC	BCBS	108
49	Indiana	$513	-22%	UHC	Aetna	115
50	Florida	$415	-37%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 67210?

In the files we analyzed, Blue Cross Blue Shield, at a median of $693 across 3,485 sampled providers. Aetna is lowest at $616, 13% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 128% of the 2026 Medicare non-facility rate of $517.38.

Which state has the highest median for CPT 67210?

Alaska has the highest median at $1,999; Florida has the lowest at $415.

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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