CPT 92202 · professional fee

Opscpy extnd on/mac draw (CPT 92202): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92202, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$17

P10 to P90: $13 to $33

vs Medicare

107%

non-facility rate $15.70

Payer spread

1.29×

UHC $19 vs Aetna $14

State spread

3.5×

AK $43 to FL $12

4,663 sampled providers6,466 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 92202 in the files analyzed, at $19, 29% above Aetna ($14), the lowest of the 4 payers shown.

The state spread is 3.5×: Alaska has the highest median at $43 and Florida the lowest at $12, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 107% of the Medicare non-facility rate ($15.70), which ranks 183rd of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $3) and widest within UnitedHealthcare ($10).

This is a top-31 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	$19	$15	$26	+10%	1	3,831	118% of Medicare
Blue Cross Blue Shield	$17	$15	$23	+3%	2	3,548	111% of Medicare
Cigna	$17	$14	$23	+2%	3	3,736	110% of Medicare
Aetna	$14	$14	$17	-14%	4	2,889	92% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($15.70)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$43	+156%	n/a	n/a	23
2	Nebraska	$31	+82%	Cigna	BCBS	71
3	Oregon	$29	+72%	UHC	Aetna	100
4	Wisconsin	$29	+71%	BCBS	Aetna	104
5	North Dakota	$27	+63%	BCBS	Aetna	33
6	South Dakota	$25	+51%	Cigna	BCBS	39
7	Iowa	$24	+45%	Cigna	Aetna	93
8	Minnesota	$23	+35%	BCBS	Aetna	95
9	Montana	$23	+34%	UHC	BCBS	36
10	Georgia	$22	+33%	UHC	Aetna	113
11	Massachusetts	$22	+31%	UHC	Aetna	116
12	Washington	$21	+25%	UHC	Cigna	120
13	Idaho	$21	+23%	Aetna	UHC	57
14	Connecticut	$20	+21%	UHC	Aetna	111
15	Colorado	$20	+20%	BCBS	Aetna	104
16	Maine	$20	+17%	UHC	Aetna	64
17	Hawaii	$20	+16%	BCBS	UHC	89
18	New Mexico	$19	+14%	UHC	Aetna	72
19	Mississippi	$19	+11%	BCBS	Cigna	103
20	Vermont	$18	+6%	UHC	BCBS	35
21	Utah	$18	+5%	Cigna	Aetna	116
22	Oklahoma	$17	+3%	BCBS	Aetna	112
23	Illinois	$17	+1%	UHC	Aetna	111
24	Michigan	$17	+1%	UHC	BCBS	112
25	Kansas	$17	+0%	BCBS	Aetna	106
26	New Hampshire	$16	-2%	UHC	BCBS	56
27	California	$16	-2%	Cigna	Aetna	122
28	Texas	$16	-4%	BCBS	Aetna	122
29	Indiana	$16	-4%	BCBS	Aetna	115
30	Missouri	$16	-7%	UHC	Aetna	110
31	Rhode Island	$16	-7%	Aetna	UHC	62
32	Ohio	$16	-7%	UHC	Aetna	111
33	Virginia	$16	-7%	UHC	Cigna	108
34	Arkansas	$15	-8%	Aetna	Cigna	92
35	New York	$15	-9%	BCBS	Aetna	109
36	Nevada	$15	-9%	BCBS	Aetna	112
37	Pennsylvania	$15	-9%	UHC	Aetna	116
38	Tennessee	$15	-10%	BCBS	Cigna	119
39	District of Columbia	$15	-10%	Aetna	BCBS	51
40	South Carolina	$15	-11%	UHC	BCBS	102
41	West Virginia	$15	-12%	UHC	Aetna	78
42	New Jersey	$15	-12%	BCBS	Cigna	117
43	Louisiana	$14	-14%	Aetna	Cigna	109
44	Alabama	$14	-14%	Aetna	Cigna	109
45	Maryland	$14	-14%	Aetna	BCBS	106
46	North Carolina	$14	-16%	UHC	BCBS	117
47	Kentucky	$14	-17%	Cigna	BCBS	112
48	Arizona	$14	-17%	UHC	BCBS	107
49	Delaware	$14	-19%	UHC	Aetna	47
50	Florida	$12	-26%	UHC	Aetna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92202?

In the files we analyzed, UnitedHealthcare, at a median of $19 across 3,831 sampled providers. Aetna is lowest at $14, 29% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 107% of the 2026 Medicare non-facility rate of $15.70.

Which state has the highest median for CPT 92202?

Alaska has the highest median at $43; Florida has the lowest at $12.

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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