CPT 92201 · professional fee

Opscpy extnd rta draw uni/bi (CPT 92201): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92201, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$27

P10 to P90: $20 to $52

vs Medicare

106%

non-facility rate $25.05

Payer spread

1.27×

UHC $29 vs Aetna $23

State spread

3.9×

AK $77 to FL $20

4,666 sampled providers6,483 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 92201 in the files analyzed, at $29, 27% above Aetna ($23), the lowest of the 4 payers shown.

The state spread is 3.9×: Alaska has the highest median at $77 and Florida the lowest at $20, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 106% of the Medicare non-facility rate ($25.05), which ranks 187th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $6) and widest within UnitedHealthcare ($16).

This is a top-30 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
UnitedHealthcare	$29	$24	$40	+10%	1	3,831	117% of Medicare
Blue Cross Blue Shield	$27	$24	$35	+3%	2	3,563	109% of Medicare
Cigna	$27	$22	$37	+1%	3	3,736	107% of Medicare
Aetna	$23	$21	$27	-13%	4	3,076	92% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($25.05)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$77	+190%	n/a	n/a	23
2	Nebraska	$47	+78%	Cigna	BCBS	71
3	Oregon	$45	+71%	UHC	Aetna	100
4	Wisconsin	$45	+69%	BCBS	Aetna	104
5	North Dakota	$43	+62%	BCBS	Aetna	33
6	South Dakota	$40	+50%	Cigna	BCBS	39
7	Iowa	$38	+44%	Cigna	Aetna	93
8	Georgia	$36	+35%	UHC	Aetna	114
9	Montana	$35	+33%	UHC	Cigna	36
9	Massachusetts	$35	+33%	UHC	Aetna	117
11	Minnesota	$34	+29%	BCBS	Aetna	95
12	Washington	$33	+26%	UHC	Cigna	120
13	Idaho	$33	+25%	Aetna	UHC	57
14	Colorado	$32	+22%	BCBS	Aetna	103
15	Connecticut	$32	+19%	UHC	Aetna	111
16	Hawaii	$31	+19%	BCBS	UHC	89
17	Maine	$31	+17%	UHC	Aetna	64
18	New Mexico	$30	+15%	UHC	Aetna	72
19	Mississippi	$29	+10%	BCBS	Cigna	103
20	Utah	$28	+7%	Cigna	Aetna	116
21	Vermont	$28	+6%	UHC	BCBS	35
22	Illinois	$27	+2%	UHC	Aetna	111
23	Oklahoma	$27	+1%	BCBS	Aetna	112
24	Kansas	$26	-1%	BCBS	Aetna	106
25	Michigan	$26	-2%	UHC	BCBS	112
26	New Hampshire	$26	-2%	UHC	BCBS	56
27	Texas	$26	-4%	BCBS	Aetna	122
28	Indiana	$26	-4%	UHC	Aetna	115
29	California	$25	-4%	Cigna	Aetna	122
30	Virginia	$25	-6%	Aetna	Cigna	109
31	Ohio	$25	-7%	UHC	Aetna	111
32	North Carolina	$25	-7%	UHC	Aetna	117
33	Rhode Island	$24	-8%	Aetna	UHC	62
34	District of Columbia	$24	-8%	Aetna	BCBS	51
35	Missouri	$24	-8%	UHC	Aetna	110
35	Nevada	$24	-8%	BCBS	Aetna	112
37	New York	$24	-9%	BCBS	Aetna	109
38	Arkansas	$24	-10%	UHC	Cigna	92
39	Pennsylvania	$24	-10%	UHC	Aetna	116
40	Tennessee	$24	-10%	BCBS	Cigna	119
41	South Carolina	$23	-12%	BCBS	Aetna	102
42	West Virginia	$23	-12%	UHC	Aetna	78
43	New Jersey	$23	-12%	BCBS	Cigna	117
44	Louisiana	$23	-13%	Aetna	Cigna	109
45	Maryland	$23	-14%	Aetna	BCBS	106
46	Kentucky	$22	-15%	Cigna	BCBS	112
47	Alabama	$22	-16%	UHC	Cigna	109
48	Arizona	$22	-16%	UHC	BCBS	108
49	Delaware	$21	-19%	UHC	Aetna	47
50	Florida	$20	-26%	UHC	Aetna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92201?

In the files we analyzed, UnitedHealthcare, at a median of $29 across 3,831 sampled providers. Aetna is lowest at $23, 27% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 106% of the 2026 Medicare non-facility rate of $25.05.

Which state has the highest median for CPT 92201?

Alaska has the highest median at $77; Florida has the lowest at $20.

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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