CPT 76857 · professional fee

Us exam pelvic limited (CPT 76857): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 76857, from their published in-network rate files.

UrologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$75

P10 to P90: $44 to $144

vs Medicare

146%

non-facility rate $51.10

Payer spread

1.44×

Cigna $82 vs Aetna $57

State spread

4.4×

AK $200 to OK $45

4,191 sampled providers4,609 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 76857 in the files analyzed, at $82, 44% above Aetna ($57), the lowest of the 4 payers shown.

The state spread is 4.4×: Alaska has the highest median at $200 and Oklahoma the lowest at $45, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 146% of the Medicare non-facility rate ($51.10), which ranks 125th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $34) and widest within Cigna ($59).

This is a top-39 code for urology 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	$82	$58	$117	+11%	1	3,372	161% of Medicare
Blue Cross Blue Shield	$82	$55	$107	+9%	2	3,192	160% of Medicare
UnitedHealthcare	$78	$56	$107	+5%	3	3,588	153% of Medicare
Aetna	$57	$48	$82	-23%	4	2,444	112% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($51.10)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$200	+168%	n/a	n/a	22
2	Oregon	$126	+69%	Cigna	Aetna	102
3	Wisconsin	$123	+65%	BCBS	Aetna	113
4	District of Columbia	$111	+49%	Cigna	BCBS	47
5	California	$100	+34%	UHC	Aetna	95
6	South Dakota	$97	+30%	Cigna	UHC	33
7	Washington	$95	+27%	Cigna	UHC	111
8	North Carolina	$95	+27%	Cigna	Aetna	107
9	Nebraska	$94	+26%	Cigna	BCBS	50
10	Iowa	$94	+26%	Cigna	Aetna	82
11	North Dakota	$93	+24%	n/a	n/a	21
12	Georgia	$92	+23%	Cigna	Aetna	118
13	New Hampshire	$92	+23%	UHC	BCBS	51
14	Delaware	$86	+16%	UHC	Cigna	28
15	Nevada	$85	+14%	Cigna	Aetna	54
16	New Jersey	$85	+14%	UHC	Aetna	104
17	Vermont	$84	+13%	UHC	BCBS	30
18	Minnesota	$84	+13%	BCBS	Aetna	111
19	Utah	$82	+9%	Aetna	Cigna	73
20	Ohio	$81	+9%	BCBS	UHC	112
21	Idaho	$80	+7%	BCBS	UHC	45
22	Colorado	$79	+6%	BCBS	Aetna	115
23	Connecticut	$79	+6%	BCBS	Aetna	114
24	Montana	$77	+4%	Cigna	BCBS	39
25	Mississippi	$77	+4%	BCBS	UHC	67
26	Virginia	$74	-1%	UHC	Aetna	104
27	Pennsylvania	$73	-3%	BCBS	Aetna	108
28	Kentucky	$72	-3%	Cigna	Aetna	116
28	West Virginia	$72	-3%	UHC	Aetna	49
30	Rhode Island	$72	-4%	UHC	BCBS	40
31	Hawaii	$71	-4%	BCBS	UHC	28
32	Illinois	$70	-6%	Cigna	BCBS	107
33	New York	$70	-6%	Cigna	Aetna	115
34	Michigan	$70	-6%	BCBS	Aetna	112
35	South Carolina	$70	-7%	BCBS	Aetna	97
36	Indiana	$68	-9%	Cigna	Aetna	124
37	Massachusetts	$67	-10%	Cigna	Aetna	103
38	Maine	$66	-12%	UHC	Aetna	48
39	Kansas	$66	-12%	BCBS	Aetna	93
40	Alabama	$65	-13%	BCBS	Cigna	116
41	Missouri	$64	-14%	Cigna	Aetna	118
42	Arkansas	$64	-15%	UHC	Aetna	66
43	Tennessee	$60	-20%	BCBS	Aetna	108
44	Arizona	$59	-20%	Cigna	BCBS	99
45	New Mexico	$59	-21%	Cigna	BCBS	34
46	Louisiana	$57	-24%	UHC	Cigna	104
47	Maryland	$51	-31%	Aetna	Cigna	102
48	Texas	$51	-32%	UHC	BCBS	124
49	Florida	$48	-36%	BCBS	Aetna	112
50	Oklahoma	$45	-39%	UHC	Aetna	108

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 76857?

In the files we analyzed, Cigna, at a median of $82 across 3,372 sampled providers. Aetna is lowest at $57, 44% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 146% of the 2026 Medicare non-facility rate of $51.10.

Which state has the highest median for CPT 76857?

Alaska has the highest median at $200; Oklahoma has the lowest at $45.

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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