CPT 72197 · professional fee

Mri pelvis w/o & w/dye (CPT 72197): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 72197, from their published in-network rate files.

Diagnostic radiologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$634

P10 to P90: $355 to $1,281

vs Medicare

190%

non-facility rate $334.34

Payer spread

1.32×

Cigna $730 vs Aetna $552

State spread

2.9×

AK $1,197 to OK $408

5,776 sampled providers7,042 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Cigna has the highest median for CPT 72197 in the files analyzed, at $730, 32% above Aetna ($552), the lowest of the 4 payers shown.

The state spread is 2.9×: Alaska has the highest median at $1,197 and Oklahoma the lowest at $408, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 190% of the Medicare non-facility rate ($334.34), which ranks 47th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $319) and widest within Cigna ($534).

This is a top-19 code for diagnostic radiology 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
Cigna	$730	$502	$1,036	+15%	1	4,481	218% of Medicare
UnitedHealthcare	$704	$505	$943	+11%	2	3,915	211% of Medicare
Blue Cross Blue Shield	$587	$424	$781	-7%	3	4,505	176% of Medicare
Aetna	$552	$425	$744	-13%	4	3,826	165% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($334.34)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$1,197	+89%	Aetna	Cigna	60
2	North Carolina	$953	+50%	Cigna	BCBS	123
3	Wyoming	$878	+39%	BCBS	Aetna	41
4	Connecticut	$857	+35%	Cigna	Aetna	119
5	Wisconsin	$818	+29%	UHC	Cigna	118
6	Washington	$803	+27%	Aetna	BCBS	117
7	Georgia	$756	+19%	Cigna	Aetna	128
8	South Dakota	$729	+15%	Cigna	Aetna	85
9	Iowa	$729	+15%	BCBS	Aetna	100
10	Nebraska	$725	+14%	UHC	Aetna	120
11	Tennessee	$725	+14%	Cigna	Aetna	128
12	Massachusetts	$719	+13%	UHC	BCBS	118
13	New Hampshire	$715	+13%	BCBS	Aetna	127
13	Maine	$715	+13%	Cigna	Aetna	127
15	Colorado	$697	+10%	BCBS	Aetna	115
16	Mississippi	$690	+9%	BCBS	UHC	115
17	New Jersey	$682	+8%	Cigna	BCBS	126
18	District of Columbia	$680	+7%	UHC	BCBS	132
19	North Dakota	$678	+7%	Cigna	Aetna	86
20	Ohio	$677	+7%	UHC	Aetna	127
21	Idaho	$670	+6%	Aetna	Cigna	124
22	Delaware	$651	+3%	UHC	Aetna	100
23	Oregon	$645	+2%	UHC	Cigna	106
24	California	$641	+1%	Cigna	Aetna	106
25	Virginia	$641	+1%	Cigna	BCBS	120
26	Kansas	$624	-1%	Aetna	UHC	116
26	Missouri	$624	-1%	Aetna	Cigna	123
28	New Mexico	$616	-3%	Cigna	BCBS	123
29	Rhode Island	$603	-5%	Cigna	BCBS	127
30	Pennsylvania	$597	-6%	UHC	Aetna	119
31	Nevada	$595	-6%	UHC	BCBS	123
32	Vermont	$594	-6%	Cigna	Aetna	63
33	West Virginia	$591	-7%	UHC	Aetna	114
34	South Carolina	$587	-7%	Cigna	Aetna	113
35	Arizona	$585	-8%	Cigna	Aetna	113
36	Louisiana	$578	-9%	Aetna	BCBS	122
37	Florida	$574	-9%	Cigna	BCBS	104
38	Arkansas	$573	-10%	UHC	BCBS	119
39	Utah	$572	-10%	Cigna	Aetna	121
40	Minnesota	$567	-11%	UHC	Aetna	123
41	Maryland	$565	-11%	UHC	BCBS	106
42	Indiana	$553	-13%	Cigna	Aetna	135
43	Montana	$546	-14%	Aetna	BCBS	69
44	Kentucky	$528	-17%	Cigna	Aetna	134
45	Alabama	$526	-17%	Cigna	UHC	126
46	Illinois	$524	-17%	UHC	BCBS	123
47	Michigan	$517	-18%	Cigna	Aetna	116
48	Hawaii	$496	-22%	BCBS	Cigna	105
49	New York	$491	-23%	Cigna	Aetna	128
50	Texas	$475	-25%	UHC	BCBS	133
51	Oklahoma	$408	-36%	Aetna	BCBS	110

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 72197?

In the files we analyzed, Cigna, at a median of $730 across 4,481 sampled providers. Aetna is lowest at $552, 32% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 190% of the 2026 Medicare non-facility rate of $334.34.

Which state has the highest median for CPT 72197?

Alaska has the highest median at $1,197; Oklahoma has the lowest at $408.

Is this a professional fee?

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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