CPT 92242 · professional fee

Fluorescein&icg angiography (CPT 92242): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92242, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$288

P10 to P90: $185 to $597

vs Medicare

86%

non-facility rate $336.35

Payer spread

1.19×

BCBS $311 vs Aetna $262

State spread

3.5×

AK $648 to FL $185

4,614 sampled providers6,281 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 92242 in the files analyzed, at $311, 19% above Aetna ($262), the lowest of the 4 payers shown.

The state spread is 3.5×: Alaska has the highest median at $648 and Florida the lowest at $185, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 86% of the Medicare non-facility rate ($336.35), which ranks 224th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $92) and widest within Blue Cross Blue Shield ($219).

This is a top-36 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	$311	$214	$433	+8%	1	3,438	93% of Medicare
Cigna	$296	$229	$436	+3%	2	3,730	88% of Medicare
UnitedHealthcare	$278	$223	$390	-3%	3	3,831	83% of Medicare
Aetna	$262	$234	$327	-9%	4	2,322	78% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($336.35)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$648	+125%	n/a	n/a	23
2	Oregon	$603	+109%	Cigna	Aetna	99
3	Iowa	$597	+107%	BCBS	Aetna	93
4	Nebraska	$532	+85%	UHC	BCBS	70
5	Wisconsin	$511	+78%	BCBS	Aetna	104
6	North Dakota	$483	+68%	BCBS	Aetna	33
7	Georgia	$449	+56%	Aetna	BCBS	113
8	Hawaii	$445	+55%	UHC	BCBS	89
9	South Dakota	$438	+52%	BCBS	UHC	39
10	Montana	$423	+47%	Cigna	BCBS	36
11	Massachusetts	$416	+45%	BCBS	Aetna	115
12	Minnesota	$383	+33%	BCBS	Aetna	95
13	Idaho	$378	+31%	Aetna	UHC	57
14	New Hampshire	$372	+29%	Cigna	Aetna	55
15	Connecticut	$365	+27%	BCBS	Aetna	109
16	Washington	$361	+25%	BCBS	Cigna	120
17	Colorado	$357	+24%	BCBS	UHC	102
18	Maine	$348	+21%	UHC	Aetna	63
19	Vermont	$340	+18%	Cigna	BCBS	33
20	Utah	$322	+12%	BCBS	UHC	115
21	Michigan	$304	+6%	BCBS	UHC	112
22	Arizona	$303	+5%	BCBS	Cigna	108
23	Virginia	$298	+4%	Aetna	UHC	105
24	New Mexico	$291	+1%	UHC	BCBS	71
25	Rhode Island	$289	+0%	BCBS	UHC	62
26	Alabama	$277	-4%	Aetna	Cigna	109
27	California	$276	-4%	BCBS	UHC	121
28	North Carolina	$275	-4%	UHC	BCBS	98
29	Kansas	$269	-7%	BCBS	Cigna	106
30	Maryland	$268	-7%	Aetna	BCBS	105
31	Ohio	$259	-10%	Cigna	BCBS	108
32	Nevada	$256	-11%	BCBS	Cigna	111
33	Louisiana	$256	-11%	Cigna	UHC	109
34	Arkansas	$255	-11%	Aetna	Cigna	91
35	Illinois	$254	-12%	Cigna	BCBS	111
36	Kentucky	$252	-13%	Aetna	BCBS	112
37	Pennsylvania	$249	-13%	BCBS	Aetna	116
38	Missouri	$249	-14%	Cigna	Aetna	109
39	District of Columbia	$247	-14%	Aetna	BCBS	51
40	West Virginia	$247	-14%	UHC	BCBS	76
41	Mississippi	$243	-16%	Aetna	Cigna	103
42	Tennessee	$242	-16%	BCBS	Cigna	119
43	New Jersey	$241	-16%	BCBS	Aetna	116
44	Texas	$235	-18%	Cigna	BCBS	122
45	Delaware	$234	-19%	Aetna	Cigna	47
46	New York	$231	-20%	Cigna	Aetna	109
47	South Carolina	$230	-20%	Aetna	Cigna	100
48	Oklahoma	$218	-24%	Cigna	BCBS	111
49	Indiana	$214	-25%	Cigna	Aetna	115
50	Florida	$185	-36%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92242?

In the files we analyzed, Blue Cross Blue Shield, at a median of $311 across 3,438 sampled providers. Aetna is lowest at $262, 19% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 86% of the 2026 Medicare non-facility rate of $336.35.

Which state has the highest median for CPT 92242?

Alaska has the highest median at $648; Florida has the lowest at $185.

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 92242

Benchmark your negotiated rates for 92242 and the rest of your book against these payer and state medians.

Request a rate benchmark