The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 75803. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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- Full state Medicaid dental network lists
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Publishing states
46
Median % of Medicare
--
Rate range
$41.36 - $1,419.02
75803 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $86.39 | -- | -- | 2026 |
| Alabama | $169.00 | -- | -- | 2026 |
| Arkansas | $194.86 | -- | -- | 2026 |
| Arizona | $74.26 | -- | -- | 2020 |
| California | $129.80 | -- | -- | 2026 |
| Colorado | $176.91 | -- | -- | 2026 |
| Connecticut | $250.02 | -- | -- | 2026 |
| District of Columbia | $145.55 | -- | Not required | 2016 |
| Delaware | $52.82* | -- | -- | 2026 |
| Georgia | $236.31 | -- | -- | 2026 |
| Hawaii | $224.19 | -- | -- | 2025 |
| Iowa | $208.32 | -- | -- | 2024 |
| Idaho | $462.77 | -- | Not required | 2026 |
| Illinois | $73.85 | -- | -- | 2026 |
| Indiana | $270.15 | -- | -- | 2024 |
| Kansas | $251.40 | -- | -- | 2024 |
| Kentucky | $196.37 | -- | -- | 2026 |
| Louisiana | $174.99 | -- | -- | 2026 |
| Massachusetts | $41.36* | -- | -- | 2025 |
| Maine | $189.36 | -- | -- | 2026 |
| Michigan | $175.05 | -- | -- | 2026 |
| Minnesota | $187.05 | -- | -- | 2026 |
| Missouri | $1,419.02 | -- | Not required | 2026 |
| Mississippi | $1,292.63 | -- | -- | 2026 |
| Montana | $242.58 | -- | -- | 2026 |
| North Carolina | $213.78 | -- | -- | 2025 |
| North Dakota | $59.33* | -- | Not required | 2026 |
| Nebraska | $303.63 | -- | -- | 2026 |
| New Hampshire | $227.17 | -- | Not required | 2026 |
| New Jersey | $90.00 | -- | Not required | 2026 |
| New Mexico | $55.37 | -- | -- | 2020 |
| Nevada | $277.08 | -- | -- | 2024 |
| New York | $221.57 | -- | -- | 2026 |
| Ohio | $190.71 | -- | -- | 2018 |
| Oklahoma | $1,393.45 | -- | -- | 2026 |
| Oregon | $43.46* | -- | -- | 2026 |
| Rhode Island | $495.53 | -- | -- | 2026 |
| South Carolina | $180.41 | -- | -- | 2011 |
| Texas | $195.57* | -- | -- | 2025 |
| Utah | $51.94* | -- | Not required | 2026 |
| Virginia | $206.72 | -- | -- | 2009 |
| Vermont | $44.83 | -- | -- | 2026 |
| Washington | $64.57 | -- | -- | 2026 |
| Wisconsin | $266.51 | -- | -- | 2010 |
| West Virginia | $1,054.81 | -- | -- | 2026 |
| Wyoming | $47.66 | -- | -- | 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 75803?
46 state Medicaid programs publish a fee-for-service rate for 75803 (lymph vessel X-ray with dye, both limbs, reading), ranging from $41.36 in Massachusetts to $1,419.02 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 75803?
Missouri publishes the highest Medicaid rate for 75803 at $1,419.02. Massachusetts publishes the lowest at $41.36.
Does 75803 require prior authorization under Medicaid?
No publishing state flags 75803 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.