CPT 67028 · professional fee

Injection eye drug (CPT 67028): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 67028, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$137

P10 to P90: $92 to $285

vs Medicare

120%

non-facility rate $114.23

Payer spread

1.20×

BCBS $154 vs Aetna $128

State spread

4.3×

AK $366 to FL $85

4,666 sampled providers6,408 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 67028 in the files analyzed, at $154, 20% above Aetna ($128), the lowest of the 4 payers shown.

The state spread is 4.3×: Alaska has the highest median at $366 and Florida the lowest at $85, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 120% of the Medicare non-facility rate ($114.23), which ranks 167th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $47) and widest within UnitedHealthcare ($107).

This is a top-3 code for ophthalmology 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	$154	$118	$205	+12%	1	3,484	135% of Medicare
UnitedHealthcare	$145	$108	$215	+6%	2	3,832	127% of Medicare
Cigna	$139	$103	$199	+1%	3	3,769	121% of Medicare
Aetna	$128	$107	$154	-7%	4	3,217	112% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($114.23)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$366	+167%	n/a	n/a	23
2	Nebraska	$231	+69%	Cigna	Aetna	71
3	Wisconsin	$220	+60%	BCBS	Aetna	103
4	Mississippi	$216	+58%	BCBS	UHC	103
5	South Dakota	$203	+48%	Cigna	BCBS	39
6	Oregon	$200	+46%	UHC	Aetna	100
7	Iowa	$185	+35%	Cigna	Aetna	93
8	Massachusetts	$184	+34%	UHC	Aetna	117
9	North Dakota	$183	+34%	UHC	Aetna	34
10	Ohio	$181	+32%	BCBS	Cigna	110
11	Alabama	$179	+31%	BCBS	UHC	111
12	North Carolina	$176	+29%	BCBS	Aetna	118
13	Georgia	$175	+28%	UHC	BCBS	114
14	Idaho	$173	+26%	Aetna	Cigna	57
15	Connecticut	$173	+26%	Cigna	Aetna	111
16	Minnesota	$163	+19%	BCBS	Aetna	94
17	Colorado	$163	+19%	Cigna	Aetna	103
18	California	$154	+13%	BCBS	Aetna	122
19	Washington	$152	+11%	BCBS	Cigna	120
20	Maine	$151	+10%	UHC	Cigna	64
21	Vermont	$150	+9%	UHC	BCBS	35
22	New Mexico	$147	+7%	UHC	BCBS	73
23	Hawaii	$145	+6%	Cigna	UHC	85
24	Montana	$142	+4%	UHC	Cigna	36
25	New Hampshire	$142	+4%	UHC	BCBS	56
26	South Carolina	$139	+1%	BCBS	UHC	102
27	West Virginia	$138	+1%	UHC	Aetna	78
28	Rhode Island	$137	+0%	UHC	BCBS	62
28	Michigan	$137	+0%	BCBS	Aetna	112
30	Illinois	$135	-1%	UHC	Aetna	111
31	Utah	$131	-4%	Cigna	UHC	116
32	Indiana	$128	-6%	BCBS	Aetna	115
33	Louisiana	$128	-7%	Aetna	Cigna	109
34	Tennessee	$126	-8%	Aetna	Cigna	120
35	Kansas	$126	-8%	BCBS	Cigna	106
36	Kentucky	$121	-12%	UHC	Cigna	112
37	New York	$120	-12%	Aetna	Cigna	109
38	Arkansas	$119	-13%	UHC	Aetna	92
39	Missouri	$119	-13%	BCBS	Cigna	110
40	Nevada	$114	-16%	BCBS	UHC	112
41	Maryland	$114	-16%	Aetna	BCBS	106
41	District of Columbia	$114	-16%	UHC	BCBS	52
43	Texas	$114	-17%	UHC	BCBS	123
44	Oklahoma	$113	-17%	BCBS	Aetna	112
45	Delaware	$112	-18%	UHC	Cigna	47
46	Pennsylvania	$110	-20%	UHC	Cigna	116
47	Virginia	$107	-22%	Aetna	Cigna	108
47	Arizona	$107	-22%	UHC	BCBS	108
49	New Jersey	$106	-22%	Aetna	Cigna	117
50	Florida	$85	-38%	UHC	Cigna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 67028?

In the files we analyzed, Blue Cross Blue Shield, at a median of $154 across 3,484 sampled providers. Aetna is lowest at $128, 20% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 120% of the 2026 Medicare non-facility rate of $114.23.

Which state has the highest median for CPT 67028?

Alaska has the highest median at $366; Florida has the lowest at $85.

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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