CPT 96574 · professional fee

Dbrdmt prmlg les w/pdt (CPT 96574): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 96574, from their published in-network rate files.

DermatologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$315

P10 to P90: $231 to $627

vs Medicare

118%

non-facility rate $266.87

Payer spread

1.13×

BCBS $335 vs Aetna $296

State spread

2.8×

AK $594 to FL $214

4,274 sampled providers5,628 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 96574 in the files analyzed, at $335, 13% above Aetna ($296), the lowest of the 4 payers shown.

The state spread is 2.8×: Alaska has the highest median at $594 and Florida the lowest at $214, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 118% of the Medicare non-facility rate ($266.87), which ranks 168th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $64) and widest within UnitedHealthcare ($237).

This is a top-28 code for dermatology 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	$335	$272	$438	+6%	1	3,375	126% of Medicare
UnitedHealthcare	$315	$250	$487	-0%	2	3,641	118% of Medicare
Cigna	$309	$261	$448	-2%	3	3,476	116% of Medicare
Aetna	$296	$261	$325	-6%	4	2,383	111% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($266.87)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$594	+88%	n/a	n/a	16
2	Oregon	$523	+66%	UHC	Aetna	108
3	North Dakota	$520	+65%	n/a	n/a	24
4	New Hampshire	$520	+65%	UHC	Aetna	77
5	Nebraska	$519	+64%	UHC	BCBS	48
6	South Dakota	$480	+52%	UHC	BCBS	37
7	Iowa	$461	+46%	Cigna	Aetna	63
8	Massachusetts	$457	+45%	BCBS	Aetna	116
9	Minnesota	$451	+43%	BCBS	Aetna	115
10	Georgia	$447	+42%	UHC	Aetna	115
11	Wisconsin	$446	+41%	BCBS	Aetna	99
12	Montana	$438	+39%	UHC	Cigna	44
13	Washington	$407	+29%	UHC	BCBS	106
14	Maine	$392	+24%	Cigna	UHC	40
15	Idaho	$381	+21%	Cigna	UHC	46
16	Vermont	$369	+17%	UHC	BCBS	21
17	Hawaii	$369	+17%	Cigna	BCBS	46
18	Illinois	$364	+16%	BCBS	Aetna	113
19	Connecticut	$352	+12%	UHC	BCBS	109
20	Kansas	$348	+10%	Cigna	Aetna	71
21	Colorado	$343	+9%	BCBS	Aetna	125
22	Michigan	$332	+5%	BCBS	UHC	108
23	New York	$330	+5%	Cigna	Aetna	107
24	Utah	$324	+3%	Cigna	Aetna	113
25	New Mexico	$319	+1%	UHC	BCBS	33
26	Rhode Island	$313	-1%	Cigna	BCBS	48
27	Pennsylvania	$308	-2%	BCBS	UHC	117
28	West Virginia	$305	-3%	Cigna	UHC	31
29	Texas	$301	-5%	BCBS	UHC	134
30	Nevada	$300	-5%	BCBS	Cigna	65
31	Delaware	$297	-6%	Aetna	UHC	18
32	Ohio	$296	-6%	Cigna	BCBS	115
33	Oklahoma	$296	-6%	BCBS	Aetna	80
34	North Carolina	$294	-7%	BCBS	UHC	125
35	California	$293	-7%	Cigna	UHC	98
36	Missouri	$290	-8%	UHC	Cigna	118
37	Arkansas	$289	-8%	Aetna	UHC	64
38	Virginia	$287	-9%	BCBS	UHC	119
39	Louisiana	$284	-10%	Aetna	Cigna	129
39	Mississippi	$284	-10%	Cigna	UHC	55
41	New Jersey	$283	-10%	BCBS	UHC	99
42	Indiana	$281	-11%	Cigna	Aetna	116
43	Tennessee	$278	-12%	BCBS	Aetna	122
44	District of Columbia	$268	-15%	Aetna	UHC	36
45	Maryland	$268	-15%	Aetna	BCBS	108
46	Alabama	$267	-15%	Aetna	Cigna	131
47	South Carolina	$265	-16%	BCBS	UHC	106
48	Arizona	$251	-20%	Cigna	BCBS	104
49	Kentucky	$247	-22%	UHC	BCBS	112
50	Florida	$214	-32%	Cigna	Aetna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 96574?

In the files we analyzed, Blue Cross Blue Shield, at a median of $335 across 3,375 sampled providers. Aetna is lowest at $296, 13% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 118% of the 2026 Medicare non-facility rate of $266.87.

Which state has the highest median for CPT 96574?

Alaska has the highest median at $594; Florida has the lowest at $214.

Is this the surgeon, physician or facility payment?

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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