CPT 88313 · professional fee

Special stains group 2 (CPT 88313): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 88313, from their published in-network rate files.

GastroenterologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$71

P10 to P90: $33 to $166

vs Medicare

88%

non-facility rate $80.83

Payer spread

1.63×

BCBS $86 vs Cigna $53

State spread

4.3×

AK $179 to OK $42

4,389 sampled providers4,801 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 88313 in the files analyzed, at $86, 63% above Cigna ($53), the lowest of the 4 payers shown.

The state spread is 4.3×: Alaska has the highest median at $179 and Oklahoma the lowest at $42, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 88% of the Medicare non-facility rate ($80.83), which ranks 221st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $40) and widest within Cigna ($62).

This is a top-28 code for gastroenterology 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	$86	$33	$125	+22%	1	3,277	106% of Medicare
Aetna	$79	$63	$103	+11%	2	2,475	98% of Medicare
UnitedHealthcare	$67	$46	$90	-5%	3	3,757	83% of Medicare
Cigna	$53	$37	$99	-25%	4	3,477	65% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($80.83)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$179	+153%	n/a	n/a	16
2	Minnesota	$143	+103%	BCBS	Aetna	91
2	Iowa	$143	+103%	BCBS	UHC	55
4	Nebraska	$124	+76%	Cigna	UHC	46
5	South Dakota	$124	+75%	BCBS	UHC	25
6	North Dakota	$119	+68%	BCBS	UHC	20
7	Hawaii	$112	+59%	Cigna	BCBS	45
8	Oregon	$109	+53%	BCBS	Aetna	103
9	Connecticut	$103	+46%	UHC	Cigna	122
10	Washington	$99	+41%	BCBS	Cigna	96
11	Michigan	$97	+37%	BCBS	UHC	109
12	Wisconsin	$92	+30%	BCBS	Cigna	110
13	New Jersey	$90	+28%	BCBS	Aetna	116
14	California	$87	+23%	UHC	Cigna	107
15	Vermont	$87	+23%	Cigna	UHC	23
16	Massachusetts	$86	+21%	BCBS	Aetna	109
17	New Hampshire	$85	+21%	BCBS	UHC	74
18	Colorado	$85	+20%	Aetna	Cigna	124
19	Mississippi	$84	+19%	Aetna	UHC	92
20	Kansas	$84	+19%	BCBS	Aetna	62
21	Maine	$80	+13%	Cigna	Aetna	53
22	Utah	$77	+9%	BCBS	Cigna	88
23	Louisiana	$76	+8%	Aetna	BCBS	122
24	Pennsylvania	$74	+5%	BCBS	Cigna	114
25	District of Columbia	$74	+5%	Aetna	BCBS	50
26	New York	$73	+3%	Cigna	Aetna	130
27	Missouri	$71	+0%	BCBS	Cigna	135
28	Ohio	$71	+0%	BCBS	Cigna	121
29	Illinois	$70	-0%	UHC	BCBS	115
30	Rhode Island	$70	-1%	UHC	Cigna	66
31	West Virginia	$70	-1%	UHC	Cigna	45
32	Delaware	$67	-5%	Aetna	Cigna	29
33	Arkansas	$67	-5%	Aetna	UHC	81
34	Alabama	$67	-5%	Aetna	Cigna	115
35	Georgia	$67	-5%	Aetna	Cigna	124
36	Maryland	$66	-6%	Aetna	Cigna	109
37	Idaho	$61	-13%	Aetna	UHC	52
38	Kentucky	$61	-14%	Aetna	BCBS	123
39	Virginia	$57	-19%	Aetna	BCBS	116
40	North Carolina	$57	-19%	Aetna	Cigna	103
41	Tennessee	$55	-22%	Aetna	Cigna	110
42	New Mexico	$53	-25%	Aetna	BCBS	58
43	Arizona	$52	-26%	Aetna	Cigna	98
44	South Carolina	$46	-34%	Aetna	Cigna	113
44	Indiana	$46	-34%	UHC	BCBS	109
44	Nevada	$46	-34%	BCBS	Cigna	84
47	Texas	$45	-37%	Aetna	BCBS	132
48	Florida	$44	-37%	Aetna	BCBS	115
49	Montana	$44	-38%	Cigna	BCBS	28
50	Oklahoma	$42	-41%	BCBS	Cigna	98

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 88313?

In the files we analyzed, Blue Cross Blue Shield, at a median of $86 across 3,277 sampled providers. Cigna is lowest at $53, 63% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 88% of the 2026 Medicare non-facility rate of $80.83.

Which state has the highest median for CPT 88313?

Alaska has the highest median at $179; Oklahoma has the lowest at $42.

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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