CPT 92014 · professional fee

Compre oph exam est pt 1/> (CPT 92014): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92014, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$101

P10 to P90: $68 to $209

vs Medicare

162%

facility rate $62.13

Payer spread

1.66×

UHC $139 vs Aetna $84

State spread

3.4×

AK $265 to NC $78

4,687 sampled providers6,969 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

UnitedHealthcare has the highest median for CPT 92014 in the files analyzed, at $139, 66% above Aetna ($84), the lowest of the 4 payers shown.

The state spread is 3.4×: Alaska has the highest median at $265 and North Carolina the lowest at $78, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 162% of the Medicare facility rate ($62.13), which ranks 92nd of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $30) and widest within Cigna ($73).

This is the #1 code for ophthalmology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

The Medicare comparison uses the facility rate: the non-facility rate ($127.26) is 2.0× higher because it includes device or supply cost that professional-fee contracts do not.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
UnitedHealthcare	$139	$113	$192	+38%	1	3,821	224% of Medicare
Cigna	$97	$75	$148	-4%	2	3,774	156% of Medicare
Blue Cross Blue Shield	$90	$80	$119	-11%	3	3,843	145% of Medicare
Aetna	$84	$72	$102	-17%	4	3,412	135% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare facility ($62.13)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$265	+162%	BCBS	Aetna	24
2	Wisconsin	$169	+67%	UHC	Aetna	104
3	Iowa	$167	+65%	UHC	Aetna	93
4	Hawaii	$164	+63%	Cigna	BCBS	89
4	Oregon	$164	+63%	UHC	BCBS	99
6	South Dakota	$156	+55%	UHC	BCBS	39
6	Nebraska	$156	+55%	UHC	Aetna	71
8	North Dakota	$151	+49%	UHC	Aetna	34
9	Massachusetts	$148	+47%	UHC	BCBS	118
10	Georgia	$139	+38%	UHC	BCBS	114
11	Minnesota	$134	+33%	UHC	Aetna	95
12	Washington	$127	+26%	UHC	Cigna	120
13	Idaho	$125	+24%	UHC	BCBS	57
14	Vermont	$123	+22%	UHC	Cigna	35
15	Maine	$121	+20%	UHC	BCBS	64
16	Colorado	$118	+17%	UHC	Aetna	104
17	Montana	$117	+16%	UHC	BCBS	36
18	Connecticut	$114	+13%	UHC	Aetna	111
19	New Mexico	$108	+7%	UHC	BCBS	74
20	New Hampshire	$107	+6%	UHC	BCBS	56
21	Illinois	$104	+3%	UHC	Aetna	112
22	New York	$103	+2%	UHC	Aetna	110
23	Oklahoma	$102	+1%	UHC	Aetna	112
24	Texas	$99	-2%	UHC	Aetna	123
25	Kansas	$99	-2%	UHC	Aetna	106
26	Mississippi	$99	-2%	UHC	Cigna	103
27	Utah	$97	-4%	UHC	BCBS	116
28	California	$97	-4%	UHC	BCBS	122
29	Tennessee	$96	-5%	UHC	Cigna	120
30	Arkansas	$96	-5%	UHC	BCBS	92
31	Ohio	$95	-6%	UHC	Aetna	111
32	Kentucky	$94	-7%	UHC	BCBS	112
33	Missouri	$91	-10%	UHC	Aetna	110
34	District of Columbia	$90	-11%	UHC	Aetna	52
35	Virginia	$89	-12%	UHC	Aetna	109
36	West Virginia	$89	-12%	UHC	Cigna	78
37	Louisiana	$88	-12%	UHC	Cigna	109
38	Michigan	$88	-12%	UHC	BCBS	113
39	Nevada	$87	-13%	UHC	Aetna	112
40	Rhode Island	$86	-14%	Aetna	UHC	62
41	New Jersey	$86	-15%	BCBS	Aetna	117
42	Indiana	$86	-15%	UHC	Aetna	116
43	Pennsylvania	$85	-16%	UHC	Aetna	116
44	Delaware	$82	-19%	UHC	Aetna	47
45	Maryland	$81	-19%	UHC	Aetna	106
46	Alabama	$81	-20%	UHC	Cigna	113
47	Florida	$80	-21%	UHC	Cigna	113
47	Arizona	$80	-21%	UHC	Aetna	110
47	South Carolina	$80	-21%	UHC	Cigna	103
50	North Carolina	$78	-23%	UHC	BCBS	118

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92014?

In the files we analyzed, UnitedHealthcare, at a median of $139 across 3,821 sampled providers. Aetna is lowest at $84, 66% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 162% of the 2026 Medicare facility rate of $62.13.

Which state has the highest median for CPT 92014?

Alaska has the highest median at $265; North Carolina has the lowest at $78.

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.

See how your contracts compare for CPT 92014

Benchmark your negotiated rates for 92014 and the rest of your book against these payer and state medians.

Request a rate benchmark