Benchmark

Reimbursement index by state: ophthalmology

Metric: index_vs_national (100 = specialty national median).

Snapshot Aug 2026

What the data shows

Metric: index_vs_national (100 = specialty national median) · 50 items

1

Alaska ranks first at 259.20; Florida ranks last of 50 at 68.10.

2

The spread between first and last is 3.81× (191.10 points on this metric).

3

The median value across the 50 items is 97.90.

4

23 of 50 items sit above 100 (the reference median) and 27 sit below it.

How to read this ranking

An index of 100 means rates equal the national median for the same procedures. Above 100 means commercial rates in that market are higher than the national median; below 100 means lower. States are compared on the same set of procedure codes, so differences reflect price, not procedure mix.

Reimbursement index by state: ophthalmology

50 items ranked

Rank	Item	Value	Level
1	Alaska	259.20
2	Nebraska	168.10
3	Oregon	164.00
4	Wisconsin	163.60
5	South Dakota	153.00
6	North Dakota	149.10
7	Iowa	147.20
8	Massachusetts	134.70
9	Georgia	132.50
10	Minnesota	128.80
11	Connecticut	126.10
12	Montana	125.20
13	Idaho	125.00
14	Washington	121.60
15	Vermont	117.00
16	Colorado	116.50
17	Hawaii	115.40
18	Maine	113.10
19	New Hampshire	111.20
20	New Mexico	109.80
21	Mississippi	109.60
22	Michigan	102.30
23	Utah	101.70
24	Illinois	98.90
25	Rhode Island	97.90
26	North Carolina	97.60
27	Kansas	96.50
28	California	95.60
29	Arkansas	94.30
30	Alabama	93.80
31	Ohio	93.10
32	Tennessee	92.70
33	Indiana	92.60
34	New York	91.50
35	West Virginia	90.60
36	Missouri	89.50
37	Nevada	88.50
38	Kentucky	88.30
39	Louisiana	88.10
40	South Carolina	87.20
41	District of Columbia	86.60
42	Virginia	86.20
43	Texas	85.80
44	Oklahoma	85.30
45	Maryland	85.30
46	New Jersey	84.80
47	Pennsylvania	84.30
48	Delaware	81.70
49	Arizona	79.30
50	Florida	68.10

Frequently asked questions

What does this ranking measure?

index_vs_national (100 = specialty national median). An index of 100 means rates equal the national median for the same procedures. Above 100 means commercial rates in that market are higher than the national median; below 100 means lower. States are compared on the same set of procedure codes, so differences reflect price, not procedure mix.

Who ranks first?

Alaska, at 259.20.

How often is this updated?

It is rebuilt from each monthly snapshot of the payers' published files; this page uses August 2026.

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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