The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 75801. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Publishing states
46
Median % of Medicare
--
Rate range
$30.80 - $574.67
75801 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $66.31 | -- | -- | 2026 |
| Alabama | $94.10 | -- | -- | 2026 |
| Arkansas | $182.01 | -- | -- | 2026 |
| Arizona | $57.96 | -- | -- | 2020 |
| California | $129.80 | -- | -- | 2026 |
| Colorado | $176.91 | -- | -- | 2026 |
| Connecticut | $241.06 | -- | -- | 2026 |
| District of Columbia | $136.41 | -- | Not required | 2016 |
| Delaware | $42.45* | -- | -- | 2026 |
| Georgia | $220.95 | -- | -- | 2026 |
| Hawaii | $210.73 | -- | -- | 2025 |
| Iowa | $193.82 | -- | -- | 2024 |
| Idaho | $35.05* | -- | Not required | 2026 |
| Illinois | $34.30 | -- | -- | 2026 |
| Indiana | $253.48 | -- | -- | 2024 |
| Kansas | $234.62 | -- | -- | 2024 |
| Kentucky | $181.33 | -- | -- | 2026 |
| Louisiana | $163.57 | -- | -- | 2026 |
| Massachusetts | $30.80* | -- | -- | 2025 |
| Maine | $181.43 | -- | -- | 2026 |
| Michigan | $164.71 | -- | -- | 2026 |
| Minnesota | $195.03 | -- | -- | 2026 |
| Missouri | $565.48 | -- | Not required | 2026 |
| Mississippi | $533.41 | -- | -- | 2026 |
| Montana | $188.51 | -- | -- | 2026 |
| North Carolina | $200.81 | -- | -- | 2025 |
| North Dakota | $46.56* | -- | Not required | 2026 |
| Nebraska | $282.02 | -- | -- | 2026 |
| New Hampshire | $217.79 | -- | Not required | 2026 |
| New Jersey | $60.00 | -- | Not required | 2026 |
| New Mexico | $41.99 | -- | -- | 2023 |
| Nevada | $258.47 | -- | -- | 2024 |
| New York | $210.10 | -- | -- | 2026 |
| Ohio | $177.46 | -- | -- | 2018 |
| Oklahoma | $574.67 | -- | -- | 2026 |
| Oregon | $34.64* | -- | -- | 2026 |
| Rhode Island | $495.53 | -- | -- | 2026 |
| South Carolina | $167.65 | -- | -- | 2011 |
| Texas | $194.04* | -- | -- | 2025 |
| Utah | $41.65* | -- | Not required | 2026 |
| Virginia | $194.29 | -- | -- | 2009 |
| Vermont | $35.39 | -- | -- | 2026 |
| Washington | $53.65 | -- | -- | 2026 |
| Wisconsin | $249.30 | -- | -- | 2010 |
| West Virginia | $436.76 | -- | -- | 2026 |
| Wyoming | $36.28 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related lab & imaging codes
- 70030 - X-ray of the eye for a foreign body
- 70100 - Jaw (mandible) X-ray, up to 3 views
- 70110 - Jaw (mandible) X-ray, 4 or more views
- 70120 - X-ray of the mastoids, under 3 views per side
- 70130 - X-ray of the mastoids, complete
- 70134 - X-ray of the inner ear canals, complete
- 70140 - Facial bone X-ray, under 3 views
- 70150 - Facial bone X-ray, complete, 3 or more views
Frequently asked questions
How much does Medicaid pay for 75801?
46 state Medicaid programs publish a fee-for-service rate for 75801 (lymph vessel X-ray with dye, one limb, reading), ranging from $30.80 in Massachusetts to $574.67 in Oklahoma. The full table on this page lists every publishing state's current rate.
Which state pays the most for 75801?
Oklahoma publishes the highest Medicaid rate for 75801 at $574.67. Massachusetts publishes the lowest at $30.80.
Does 75801 require prior authorization under Medicaid?
No publishing state flags 75801 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.