CPT 92136 · professional fee

Ophthalmic biometry (CPT 92136): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92136, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$69

P10 to P90: $43 to $133

vs Medicare

143%

non-facility rate $48.10

Payer spread

1.40×

Cigna $75 vs Aetna $54

State spread

3.3×

AK $153 to FL $46

4,661 sampled providers6,324 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Cigna has the highest median for CPT 92136 in the files analyzed, at $75, 40% above Aetna ($54), the lowest of the 4 payers shown.

The state spread is 3.3×: Alaska has the highest median at $153 and Florida the lowest at $46, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 143% of the Medicare non-facility rate ($48.10), which ranks 138th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within UnitedHealthcare (interquartile range $44) and widest within Blue Cross Blue Shield ($48).

This is a top-15 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
Cigna	$75	$55	$104	+10%	1	3,758	157% of Medicare
UnitedHealthcare	$74	$61	$105	+7%	2	3,829	154% of Medicare
Blue Cross Blue Shield	$71	$51	$99	+3%	3	3,440	148% of Medicare
Aetna	$54	$44	$77	-22%	4	3,312	112% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($48.10)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$153	+123%	BCBS	Aetna	24
2	Iowa	$119	+72%	Cigna	Aetna	93
3	Oregon	$110	+59%	UHC	Aetna	100
4	Connecticut	$105	+53%	Cigna	BCBS	111
5	South Dakota	$104	+52%	UHC	BCBS	39
6	Wisconsin	$104	+50%	BCBS	Aetna	104
7	Nebraska	$98	+42%	Cigna	Aetna	71
8	North Dakota	$95	+38%	BCBS	Aetna	33
9	Massachusetts	$92	+34%	UHC	Cigna	118
10	Georgia	$90	+30%	Cigna	Aetna	115
11	Vermont	$85	+23%	UHC	Cigna	35
12	California	$85	+23%	Cigna	UHC	122
13	New Hampshire	$83	+21%	UHC	BCBS	56
14	Minnesota	$83	+21%	UHC	Aetna	95
15	Washington	$83	+20%	Cigna	BCBS	120
16	Mississippi	$81	+18%	BCBS	Aetna	103
17	Arkansas	$80	+17%	Aetna	UHC	92
18	Colorado	$78	+13%	UHC	Aetna	103
19	Idaho	$77	+12%	UHC	BCBS	57
20	Alabama	$76	+11%	BCBS	Aetna	111
21	New Mexico	$76	+10%	Cigna	BCBS	74
22	Montana	$74	+8%	UHC	BCBS	36
23	Utah	$74	+7%	Cigna	BCBS	116
24	Maine	$70	+2%	UHC	Cigna	63
25	Ohio	$68	-1%	BCBS	Aetna	111
26	Indiana	$68	-1%	BCBS	Aetna	115
27	Kentucky	$67	-3%	Cigna	Aetna	112
28	New York	$66	-4%	BCBS	Cigna	110
29	Delaware	$66	-4%	Cigna	Aetna	47
30	Kansas	$66	-5%	BCBS	Aetna	106
31	Missouri	$66	-5%	BCBS	Aetna	110
32	Nevada	$65	-5%	Cigna	Aetna	112
33	North Carolina	$65	-6%	Cigna	Aetna	101
34	Tennessee	$64	-8%	BCBS	Cigna	120
35	Illinois	$63	-8%	UHC	BCBS	111
36	Hawaii	$62	-10%	BCBS	UHC	89
37	Rhode Island	$62	-10%	Aetna	BCBS	62
38	South Carolina	$62	-10%	Cigna	Aetna	103
39	New Jersey	$61	-12%	BCBS	Cigna	117
40	Virginia	$60	-13%	UHC	BCBS	109
40	District of Columbia	$60	-13%	Cigna	BCBS	51
42	Maryland	$59	-15%	Cigna	BCBS	106
43	West Virginia	$59	-15%	UHC	Cigna	78
44	Louisiana	$58	-15%	Aetna	Cigna	109
45	Pennsylvania	$58	-16%	UHC	Aetna	116
46	Michigan	$57	-18%	UHC	BCBS	112
47	Oklahoma	$55	-20%	UHC	BCBS	112
48	Texas	$49	-29%	UHC	BCBS	123
49	Arizona	$48	-30%	UHC	Aetna	109
50	Florida	$46	-33%	UHC	Cigna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92136?

In the files we analyzed, Cigna, at a median of $75 across 3,758 sampled providers. Aetna is lowest at $54, 40% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 143% of the 2026 Medicare non-facility rate of $48.10.

Which state has the highest median for CPT 92136?

Alaska has the highest median at $153; Florida has the lowest at $46.

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.

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