The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 75805. 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
$28.67 - $2,846.31
75805 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $60.15 | -- | -- | 2026 |
| Alabama | $85.87 | -- | -- | 2026 |
| Arkansas | $200.89 | -- | -- | 2026 |
| Arizona | $57.47 | -- | -- | 2020 |
| California | $130.76 | -- | -- | 2026 |
| Colorado | $176.91 | -- | -- | 2026 |
| Connecticut | $263.91 | -- | -- | 2026 |
| District of Columbia | $150.73 | -- | Not required | 2016 |
| Delaware | $36.84* | -- | -- | 2026 |
| Georgia | $243.97 | -- | -- | 2026 |
| Hawaii | $233.06 | -- | -- | 2025 |
| Iowa | $213.82 | -- | -- | 2024 |
| Idaho | $1,113.12 | -- | Not required | 2026 |
| Illinois | $75.12 | -- | -- | 2026 |
| Indiana | $279.88 | -- | -- | 2024 |
| Kansas | $258.26 | -- | -- | 2024 |
| Kentucky | $199.73 | -- | -- | 2026 |
| Louisiana | $179.71 | -- | -- | 2026 |
| Massachusetts | $28.67* | -- | -- | 2025 |
| Maine | $197.27 | -- | -- | 2026 |
| Michigan | $180.90 | -- | -- | 2026 |
| Minnesota | $191.68 | -- | -- | 2026 |
| Missouri | $2,846.31 | -- | Not required | 2026 |
| Mississippi | $2,532.04 | -- | -- | 2026 |
| Montana | $168.38 | -- | -- | 2026 |
| North Carolina | $221.53 | -- | -- | 2025 |
| North Dakota | $41.30* | -- | Not required | 2026 |
| Nebraska | $281.27 | -- | -- | 2026 |
| New Hampshire | $238.58 | -- | Not required | 2026 |
| New Jersey | $75.60 | -- | Not required | 2026 |
| New Mexico | $38.52 | -- | -- | 2020 |
| Nevada | $285.45 | -- | -- | 2024 |
| New York | $231.83 | -- | -- | 2026 |
| Ohio | $195.84 | -- | -- | 2018 |
| Oklahoma | $2,731.18 | -- | -- | 2026 |
| Oregon | $30.30* | -- | -- | 2026 |
| Rhode Island | $495.53 | -- | -- | 2026 |
| South Carolina | $167.27 | -- | -- | 2011 |
| Texas | $220.24* | -- | -- | 2025 |
| Utah | $36.22* | -- | Not required | 2026 |
| Virginia | $214.07 | -- | -- | 2009 |
| Vermont | $31.26 | -- | -- | 2026 |
| Washington | $49.33 | -- | -- | 2026 |
| Wisconsin | $274.53 | -- | -- | 2010 |
| West Virginia | $2,064.97 | -- | -- | 2026 |
| Wyoming | $33.18 | -- | -- | 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 75805?
46 state Medicaid programs publish a fee-for-service rate for 75805 (lymph vessel X-ray with dye, pelvis, one side, reading), ranging from $28.67 in Massachusetts to $2,846.31 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 75805?
Missouri publishes the highest Medicaid rate for 75805 at $2,846.31. Massachusetts publishes the lowest at $28.67.
Does 75805 require prior authorization under Medicaid?
No publishing state flags 75805 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.