CPT 73564 · professional fee

X-ray exam knee 4 or more (CPT 73564): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 73564, from their published in-network rate files.

Orthopedic surgerySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$60

P10 to P90: $38 to $111

vs Medicare

121%

non-facility rate $49.43

Payer spread

1.26×

Cigna $66 vs Aetna $53

State spread

5.0×

AK $181 to FL $36

5,043 sampled providers6,009 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 73564 in the files analyzed, at $66, 26% above Aetna ($53), the lowest of the 4 payers shown.

The state spread is 5.0×: Alaska has the highest median at $181 and Florida the lowest at $36, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 121% of the Medicare non-facility rate ($49.43), which ranks 166th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $27) and widest within Blue Cross Blue Shield ($44).

This is a top-12 code for orthopedic surgery 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	$66	$46	$87	+10%	1	4,034	134% of Medicare
Blue Cross Blue Shield	$65	$45	$89	+8%	2	3,876	131% of Medicare
UnitedHealthcare	$57	$44	$83	-4%	3	4,263	116% of Medicare
Aetna	$53	$44	$71	-12%	4	3,214	106% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($49.43)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$181	+202%	BCBS	Aetna	63
2	Wyoming	$121	+102%	BCBS	Cigna	65
3	Nebraska	$92	+54%	Cigna	Aetna	95
4	South Dakota	$92	+54%	BCBS	Aetna	97
5	North Dakota	$90	+50%	BCBS	Aetna	46
6	Wisconsin	$88	+48%	BCBS	Aetna	99
7	Iowa	$87	+45%	Cigna	Aetna	104
8	Washington	$86	+44%	BCBS	Aetna	101
9	Oregon	$83	+39%	Cigna	UHC	93
10	Minnesota	$81	+36%	BCBS	Aetna	102
11	Massachusetts	$73	+23%	Cigna	Aetna	111
12	Colorado	$73	+22%	UHC	Cigna	106
13	District of Columbia	$72	+20%	Cigna	BCBS	35
14	New Hampshire	$71	+19%	Cigna	Aetna	118
15	Idaho	$71	+18%	BCBS	UHC	120
16	Hawaii	$69	+16%	BCBS	Cigna	71
17	Connecticut	$67	+13%	Cigna	Aetna	114
18	Georgia	$67	+12%	Aetna	BCBS	124
19	Utah	$67	+12%	BCBS	Aetna	97
20	New Jersey	$66	+11%	BCBS	UHC	95
21	North Carolina	$65	+8%	Cigna	Aetna	114
22	Mississippi	$63	+5%	Aetna	UHC	112
23	Illinois	$63	+5%	Cigna	BCBS	104
24	Tennessee	$62	+4%	BCBS	UHC	115
25	Kansas	$60	+0%	BCBS	UHC	108
26	Pennsylvania	$60	-0%	BCBS	Aetna	103
27	Rhode Island	$59	-1%	UHC	Aetna	98
27	Vermont	$59	-1%	UHC	BCBS	35
29	Maryland	$58	-3%	Aetna	BCBS	104
30	Alabama	$58	-4%	Aetna	Cigna	118
31	Maine	$57	-4%	BCBS	Aetna	94
32	West Virginia	$57	-5%	UHC	BCBS	87
33	Ohio	$57	-5%	Aetna	UHC	110
34	Delaware	$56	-7%	BCBS	Cigna	59
35	Michigan	$55	-7%	BCBS	UHC	102
36	Virginia	$55	-8%	Cigna	Aetna	104
37	New York	$54	-9%	Cigna	Aetna	111
38	Montana	$54	-10%	Cigna	BCBS	79
39	Arkansas	$53	-11%	UHC	Aetna	120
40	South Carolina	$53	-12%	UHC	Aetna	106
41	California	$53	-12%	Cigna	Aetna	109
42	Missouri	$51	-14%	BCBS	Cigna	112
43	Arizona	$51	-14%	Cigna	BCBS	99
44	Indiana	$50	-16%	BCBS	UHC	115
45	Nevada	$50	-16%	BCBS	Cigna	108
46	Kentucky	$49	-18%	Cigna	BCBS	124
47	Louisiana	$49	-18%	BCBS	Cigna	103
48	New Mexico	$47	-21%	Cigna	BCBS	104
49	Texas	$39	-34%	UHC	BCBS	122
50	Oklahoma	$38	-36%	UHC	BCBS	100
51	Florida	$36	-40%	BCBS	Aetna	108

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 73564?

In the files we analyzed, Cigna, at a median of $66 across 4,034 sampled providers. Aetna is lowest at $53, 26% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 121% of the 2026 Medicare non-facility rate of $49.43.

Which state has the highest median for CPT 73564?

Alaska has the highest median at $181; Florida has the lowest at $36.

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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