CPT 52000
Diagnostic cystourethroscopy
- Aetna
- $90.14
- Cigna
- $456.93
- United
- $516.74
- Anthem
- $211.93
Urology reimbursement rates in Vermont
Explore urology reimbursement rates in Vermont. Public state reference averages appear below. Detailed payer comparisons are available with a state preview.
1,188,625 national provider-rate observations4 payers in national source data49 states in national dataset20 billing codes in national dataset
Rate data shownJun–Jul 2026About these rates
Urology rate explorerThree reference services
Rate measure$ per reported billing unit
Billing contextProfessional
Vermont urology reference averages
Publication period: Jun–Jul 2026CPT 52356
Ureteroscopy with lithotripsy and ureteral stent
- Aetna
- $199.15
- Cigna
- $975.75
- United
- $1,048.06
- Anthem
- $671.45
CPT 55866
Robot-assisted laparoscopic radical prostatectomy
- Aetna
- $768.19
- Cigna
- $2,994.86
- United
- $3,358.79
- Anthem
- $1,842.66
National urology rates by payer
Use the reference codes to compare payer benchmarks, then explore cystoscopy; stone procedures; prostate surgery; diagnostics; office visits. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 52000
LowerHigher
Vermont
Select a state to reveal payer percentiles and provider examples.National 52000 rate distribution
PayerMedian
Published rate$ per reported billing unit
$100$200$300$400$500
AetnaJun–Jul 2026
AetnaProviders15,771Average$245.96
$212.85median
CignaJun–Jul 2026
CignaProviders16,444Average$321.50
$270.07median
UnitedJun–Jul 2026
UnitedProviders17,704Average$414.45
$356.80median
AnthemJun–Jul 2026
AnthemProviders15,259Average$375.51
$288.04median
Each marker shows the national median published rate across billing entities for that payer.
National 52000 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 15,771 | $212.85 | $245.96 | |||
| Cigna | Jun–Jul 2026 | 16,444 | $270.07 | $321.50 | |||
| United | Jun–Jul 2026 | 17,704 | $356.80 | $414.45 | |||
| Anthem | Jun–Jul 2026 | 15,259 | $288.04 | $375.51 |
About these rates
About this rate table
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for diagnostic cystourethroscopy (52000).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific urology providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Urology provider benchmarks (CPT 52000)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| MOUNT SINAI MEDICAL CENTER UROLOGY LLCNPI 1215295639 · Tax ID 262893302 | FL | 271 | $132.86 | -$79.99 | Below P25 |
| MICHAEL MCGUIRE, M.D., LLCNPI 1821018185 · Tax ID 201839376 | IL | 1 | $160.04 | -$52.81 | Below P25 |
| JAY HEINTZ MD A PROFESSIONAL MEDICAL LLCNPI 1194928168 · Tax ID 455241379 | LA | 2 | $181.75 | -$31.10 | Below P25 |
| SOUTH NASSAU UROLOGY PCNPI 1205879335 · Tax ID 475071498 | NY | 4 | $200.74 | -$12.11 | P25 to median |
| UWH OF THE CAROLINAS, PLLCNPI 1124080445 · Tax ID 320418835 | ME | 768 | Median to P75 | ||
| MEMORIAL MEDICAL CARE PCNPI 1447236054 · Tax ID 352491455 | NY | 35 | Above P75 |
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No trial or data preparation required.Explore urology services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 5 codes | ||||
99214Established patient office visit, level 4 | $128.33 | $171.89 | $180.70 | $173.41 |
99204New patient office visit, level 4 | $185.56 | $246.24 | $267.81 | $262.27 |
99213Established patient office visit, level 3 | $87.68 | $117.88 | $124.74 | $121.26 |
99203New patient office visit, level 3 | $119.36 | $158.97 | $176.43 | $170.75 |
99215Established patient office visit, level 5 | $180.16 | $243.39 | $245.62 | $244.86 |
$ per reported billing unit · 12 codes | ||||
52000Diagnostic cystourethroscopy | $245.96 | $321.50 | $414.45 | $375.51 |
37242Vasc Embolize Occlude Artery | $6,331.01 | $7,509.67 | $14,791.40 | $11,550.02 |
55250Male Sterilization | $470.32 | $603.69 | $714.74 | $748.97 |
52356Ureteroscopy with lithotripsy and ureteral stent | $620.82 | $790.12 | $811.01 | $908.31 |
51728Bladder Function Test | $531.65 | $654.98 | $663.32 | $728.15 |
55874Transperineal placement of biodegradable peri-prostatic material, including image guidance | $2,650.98 | $3,187.25 | $6,113.26 | $5,418.71 |
55700Biopsy Prostate Needle/Punch | Not available | $577.56 | $362.37 | $276.26 |
55866Robot-assisted laparoscopic radical prostatectomy | $2,212.92 | $2,677.26 | $2,759.21 | $3,215.36 |
52310Remove Object From Bladder | $348.21 | $443.40 | $556.59 | $523.97 |
51798Bladder Function Test | $22.59 | $45.29 | $23.77 | $35.38 |
52332Insert Urinary Tract Support | $470.83 | $556.50 | $869.11 | $764.42 |
36247Catheter Placement Artery | $1,505.64 | $1,736.64 | $3,034.29 | $2,630.52 |
$ per reported billing unit · 3 codes | ||||
77014CT guidance for radiation therapy field placement | Not available | $289.32 | $201.41 | Not available |
76770Complete retroperitoneal ultrasound | $156.93 | $191.16 | $186.90 | $253.59 |
76872Ultrasound Scan Of Pelvis | $174.97 | $283.72 | $251.61 | $304.49 |
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Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
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Explore urology rates by state
Choose a state to compare payer reference averages for common services.
Questions about urology benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Diagnostic cystourethroscopy (52000). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.