The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 86972. 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
21
Median % of Medicare
--
Rate range
$2.00 - $153.58
86972 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $17.00 | -- | -- | 2026 |
| Arkansas | $34.00 | -- | -- | 2026 |
| Arizona | $28.93 | -- | -- | 2026 |
| California | $16.65 | -- | -- | 2026 |
| Colorado | $4.60 | -- | -- | 2026 |
| Connecticut | $11.40 | -- | -- | 2015 |
| Iowa | $48.29 | -- | -- | 2024 |
| Illinois | $7.98 | -- | -- | 2026 |
| Indiana | $39.04 | -- | -- | 2026 |
| Kansas | $129.47 | -- | -- | 2023 |
| Louisiana | $2.00 | -- | -- | 2026 |
| Maine | $6.00 | -- | -- | 2026 |
| Michigan | $91.03 | -- | -- | 2026 |
| Missouri | $153.58 | -- | Not required | 2026 |
| Mississippi | $126.55 | -- | -- | 2026 |
| Nebraska | $35.66 | -- | -- | 2026 |
| New Jersey | $15.00 | -- | Not required | 2026 |
| New Mexico | $47.35 | -- | -- | 2025 |
| Nevada | $21.82 | -- | -- | 2024 |
| Ohio | $17.56 | -- | -- | 2018 |
| West Virginia | $14.43 | -- | -- | 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 86972?
21 state Medicaid programs publish a fee-for-service rate for 86972 (red cell pretreatment by density gradient for antibody ID), ranging from $2.00 in Louisiana to $153.58 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 86972?
Missouri publishes the highest Medicaid rate for 86972 at $153.58. Louisiana publishes the lowest at $2.00.
Does 86972 require prior authorization under Medicaid?
No publishing state flags 86972 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.