CPT 92273 · professional fee

Full field erg w/i&r (CPT 92273): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 92273, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$142

P10 to P90: $103 to $278

vs Medicare

115%

non-facility rate $123.25

Payer spread

1.28×

UHC $153 vs Aetna $119

State spread

3.1×

AK $323 to FL $103

4,654 sampled providers6,406 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 92273 in the files analyzed, at $153, 28% above Aetna ($119), the lowest of the 4 payers shown.

The state spread is 3.1×: Alaska has the highest median at $323 and Florida the lowest at $103, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 115% of the Medicare non-facility rate ($123.25), which ranks 171st of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $25) and widest within Cigna ($87).

This is a top-38 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	$153	$123	$210	+7%	1	3,831	124% of Medicare
Cigna	$150	$116	$203	+6%	2	3,736	122% of Medicare
Blue Cross Blue Shield	$145	$124	$195	+2%	3	3,506	117% of Medicare
Aetna	$119	$117	$143	-16%	4	2,623	96% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($123.25)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$323	+128%	n/a	n/a	23
2	Oregon	$278	+96%	UHC	Aetna	99
3	Nebraska	$255	+79%	Cigna	BCBS	71
3	South Dakota	$255	+79%	BCBS	UHC	39
5	Wisconsin	$246	+73%	BCBS	Aetna	104
6	North Dakota	$239	+68%	BCBS	Aetna	33
7	Iowa	$219	+54%	Cigna	Aetna	93
8	Montana	$199	+40%	UHC	Cigna	34
9	Minnesota	$192	+35%	BCBS	Aetna	95
10	Connecticut	$187	+32%	UHC	Aetna	110
11	Georgia	$186	+31%	UHC	Aetna	111
12	Massachusetts	$185	+30%	UHC	Aetna	116
13	Washington	$180	+27%	Aetna	Cigna	120
14	Maine	$176	+24%	UHC	Aetna	64
15	Idaho	$174	+22%	Aetna	UHC	57
16	Hawaii	$167	+18%	BCBS	Cigna	89
17	Colorado	$166	+17%	BCBS	Aetna	103
18	New Hampshire	$161	+14%	UHC	Aetna	56
19	New Mexico	$158	+11%	UHC	BCBS	72
20	Vermont	$156	+10%	UHC	BCBS	35
21	Michigan	$154	+8%	BCBS	Aetna	112
22	Mississippi	$150	+6%	BCBS	Cigna	103
23	California	$149	+5%	Cigna	UHC	122
24	Utah	$145	+2%	Cigna	Aetna	116
25	Rhode Island	$142	+0%	Aetna	UHC	62
26	Illinois	$139	-2%	Cigna	BCBS	111
27	North Carolina	$139	-2%	Cigna	Aetna	117
28	Nevada	$135	-5%	BCBS	Aetna	112
29	New York	$134	-6%	BCBS	Aetna	109
30	Texas	$133	-7%	BCBS	Aetna	122
31	Kansas	$132	-7%	UHC	Aetna	106
32	Missouri	$132	-7%	BCBS	Aetna	110
33	Virginia	$131	-8%	UHC	Aetna	108
34	Ohio	$130	-9%	UHC	Aetna	110
35	Tennessee	$129	-9%	BCBS	Cigna	119
36	West Virginia	$127	-11%	UHC	Cigna	78
37	Indiana	$127	-11%	Cigna	Aetna	115
38	South Carolina	$127	-11%	BCBS	Aetna	101
39	District of Columbia	$126	-11%	Aetna	BCBS	52
40	Arkansas	$126	-11%	Aetna	Cigna	92
41	Pennsylvania	$125	-12%	Cigna	BCBS	116
42	Alabama	$124	-13%	Aetna	UHC	109
43	New Jersey	$123	-14%	BCBS	Cigna	117
44	Delaware	$121	-15%	UHC	Cigna	47
45	Arizona	$121	-15%	UHC	Aetna	107
46	Oklahoma	$120	-15%	Cigna	BCBS	112
47	Maryland	$117	-17%	Aetna	BCBS	105
47	Louisiana	$117	-17%	Aetna	Cigna	109
47	Kentucky	$117	-17%	Cigna	BCBS	112
50	Florida	$103	-28%	UHC	Aetna	112

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 92273?

In the files we analyzed, UnitedHealthcare, at a median of $153 across 3,831 sampled providers. Aetna is lowest at $119, 28% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 115% of the 2026 Medicare non-facility rate of $123.25.

Which state has the highest median for CPT 92273?

Alaska has the highest median at $323; Florida has the lowest at $103.

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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