The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 86794. 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
$29/mo after the trial. Cancel anytime.
Publishing states
38
Median % of Medicare
97.5%
Rate range
$11.09 - $28.26
86794 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $20.80 | 123.4% | -- | 2026 |
| Arizona | $16.85 | 100% | -- | 2026 |
| California | $14.97 | 88.8% | -- | 2026 |
| Connecticut | $16.09 | 95.5% | -- | 2018 |
| District of Columbia | $13.48 | 80% | Not required | 2020 |
| Delaware | $16.51 | 98% | -- | 2026 |
| Georgia | $16.64 | 98.8% | -- | 2026 |
| Hawaii | $12.48 | 74.1% | -- | 2025 |
| Iowa | $17.33 | 102.8% | -- | 2024 |
| Idaho | $14.56 | 86.4% | Required | 2025 |
| Illinois | $12.14 | 72% | -- | 2018 |
| Indiana | $16.85 | 100% | -- | 2020 |
| Kentucky | $16.85 | 100% | -- | 2026 |
| Louisiana | $15.60 | 92.6% | -- | 2026 |
| Massachusetts | $14.86 | 88.2% | -- | 2024 |
| Michigan | $13.96 | 82.8% | -- | 2026 |
| Minnesota | $16.85 | 100% | -- | 2020 |
| Missouri | $15.17 | -- | Not required | 2026 |
| Mississippi | $15.17 | 90% | -- | 2026 |
| Montana | $16.84 | 99.9% | -- | 2026 |
| North Carolina | $17.90 | 106.2% | -- | 2025 |
| North Dakota | $16.85 | 100% | Not required | 2026 |
| New Jersey | $13.48 | 80% | Not required | 2026 |
| Nevada | $11.09 | 65.8% | -- | 2024 |
| Ohio | $12.64 | 75% | -- | 2021 |
| Oklahoma | $14.99 | 89% | -- | 2026 |
| Oregon | $13.48* | 80% | -- | 2026 |
| Pennsylvania | $16.64 | -- | -- | 2018 |
| Rhode Island | $28.26 | 167.7% | -- | 2026 |
| South Carolina | $13.14 | 78% | -- | 2026 |
| Texas | $23.08* | 137% | -- | 2021 |
| Utah | $16.80* | 99.7% | Not required | 2026 |
| Virginia | $16.85 | 100% | -- | 2020 |
| Vermont | $16.43 | 97.5% | -- | 2026 |
| Washington | $13.48 | 80% | -- | 2026 |
| Wisconsin | $16.64 | 98.8% | -- | 2018 |
| West Virginia | $15.17 | 90% | -- | 2026 |
| Wyoming | $18.25 | 108.3% | -- | 2021 |
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 86794?
38 state Medicaid programs publish a fee-for-service rate for 86794 (zika virus IgM antibody test), ranging from $11.09 in Nevada to $28.26 in Rhode Island, with a median of 97.5% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 86794?
Rhode Island publishes the highest Medicaid rate for 86794 at $28.26 (167.7% of the national Medicare amount). Nevada publishes the lowest at $11.09.
Does 86794 require prior authorization under Medicaid?
1 of the 38 publishing states flag 86794 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".