CPT 76536 · professional fee

Us exam of head and neck (CPT 76536): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 76536, 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

$154

P10 to P90: $97 to $288

vs Medicare

142%

non-facility rate $108.55

Payer spread

1.37×

UHC $179 vs Aetna $130

State spread

3.0×

AK $278 to OK $93

5,810 sampled providers7,142 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 76536 in the files analyzed, at $179, 37% above Aetna ($130), the lowest of the 4 payers shown.

The state spread is 3.0×: Alaska has the highest median at $278 and Oklahoma the lowest at $93, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 142% of the Medicare non-facility rate ($108.55), which ranks 139th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $66) and widest within UnitedHealthcare ($116).

This is a top-27 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
UnitedHealthcare	$179	$130	$246	+16%	1	3,959	164% of Medicare
Cigna	$161	$126	$228	+4%	2	4,621	149% of Medicare
Blue Cross Blue Shield	$151	$110	$199	-2%	3	4,564	139% of Medicare
Aetna	$130	$110	$177	-16%	4	3,884	120% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($108.55)

Rates by state

Median across payers · 51 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$278	+80%	Aetna	Cigna	61
2	Washington	$226	+47%	Cigna	Aetna	117
3	Wisconsin	$223	+45%	UHC	Cigna	118
4	South Dakota	$217	+40%	Cigna	Aetna	85
5	Wyoming	$213	+38%	BCBS	Aetna	41
6	Nebraska	$204	+32%	Cigna	Aetna	121
7	Iowa	$199	+29%	Cigna	Aetna	100
8	North Dakota	$194	+26%	BCBS	Aetna	86
9	Oregon	$192	+25%	UHC	BCBS	106
10	Idaho	$181	+17%	BCBS	UHC	125
11	Colorado	$178	+16%	UHC	Aetna	123
12	North Carolina	$177	+14%	UHC	Aetna	124
13	Montana	$174	+13%	Aetna	UHC	69
14	Georgia	$165	+7%	UHC	Aetna	128
14	Ohio	$165	+7%	UHC	Cigna	128
16	New Hampshire	$162	+5%	UHC	Aetna	127
17	Vermont	$160	+3%	UHC	Aetna	63
18	Hawaii	$160	+3%	UHC	BCBS	105
19	Michigan	$159	+3%	Cigna	Aetna	116
20	Missouri	$159	+3%	UHC	Aetna	124
21	West Virginia	$158	+2%	Cigna	BCBS	117
22	Connecticut	$157	+2%	UHC	Aetna	124
22	Massachusetts	$157	+2%	UHC	Aetna	118
24	Maine	$156	+1%	UHC	Aetna	127
25	Tennessee	$155	+0%	UHC	Aetna	128
26	District of Columbia	$153	-1%	UHC	BCBS	133
27	Virginia	$152	-1%	UHC	BCBS	123
28	Mississippi	$148	-4%	BCBS	UHC	115
29	Arkansas	$144	-7%	UHC	BCBS	121
30	Louisiana	$143	-7%	Cigna	UHC	122
31	Rhode Island	$143	-8%	Cigna	Aetna	126
32	Kansas	$142	-8%	Cigna	Aetna	116
33	Pennsylvania	$142	-8%	UHC	Aetna	120
34	Minnesota	$141	-8%	UHC	Aetna	123
35	South Carolina	$140	-9%	UHC	Aetna	113
35	New York	$140	-9%	Cigna	Aetna	128
37	Alabama	$138	-10%	BCBS	UHC	126
38	New Jersey	$137	-11%	UHC	Aetna	126
39	California	$137	-11%	UHC	BCBS	107
40	Utah	$136	-12%	UHC	Cigna	121
41	Maryland	$136	-12%	UHC	BCBS	107
42	New Mexico	$135	-13%	UHC	BCBS	123
43	Florida	$134	-13%	Cigna	BCBS	107
44	Delaware	$130	-16%	UHC	Aetna	98
44	Nevada	$130	-16%	UHC	BCBS	123
46	Illinois	$127	-18%	UHC	BCBS	124
47	Arizona	$126	-18%	Cigna	Aetna	115
48	Kentucky	$124	-20%	Cigna	BCBS	133
49	Texas	$118	-24%	UHC	BCBS	133
50	Indiana	$112	-27%	UHC	Aetna	136
51	Oklahoma	$93	-40%	UHC	BCBS	110

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 76536?

In the files we analyzed, UnitedHealthcare, at a median of $179 across 3,959 sampled providers. Aetna is lowest at $130, 37% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 142% of the 2026 Medicare non-facility rate of $108.55.

Which state has the highest median for CPT 76536?

Alaska has the highest median at $278; Oklahoma has the lowest at $93.

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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