How does Anthem Blue Cross Blue Shield (GA)'s rate for CPT 92014 compare to Medicare?

The Anthem Blue Cross Blue Shield (GA) local median of $81.50 is 64% of Medicare's national non-facility rate of $127.26 for CPT 92014.

Reddenda · Rate Intelligence · Los Angeles-Long Beach-Anaheim, CA

92014 under Anthem Blue Cross Blue Shield (GA), for Los Angeles-Long Beach-Anaheim, CA providers

Name: Anthem Blue Cross Blue Shield (GA) rates for CPT 92014 among Los Angeles-Long Beach-Anaheim, CA providers
Creator: Reddenda

Eye exam, established patient, comprehensive · Local peer median $81.50 · High confidence

$81.50 local peer median. Anthem Blue Cross Blue Shield (GA)'s published rate file lists a local peer median of $81.50 for CPT 92014 (Eye exam, established patient, comprehensive) among 1219 indexed providers in Los Angeles-Long Beach-Anaheim, CA. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $176.99, 117% above the median. A provider billed below this median is being paid less than peers holding the identical Anthem Blue Cross Blue Shield (GA) contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 1219 providers · 1219 rate records

P10

$66.74

P25

$67.40

Median

$81.50

P75

$99.13

P90 (target)

$176.99

P10$66.74

P25$67.40

Median (P50)$81.50

P75$99.13

P90 target$176.99

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $55 – $708.50

The local peer median for CPT 92014 under Anthem Blue Cross Blue Shield (GA) for Los Angeles-Long Beach-Anaheim, CA providers is $81.50, drawn from 1219 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
The bottom of the local market (P10) is $66.74 and the top (P90) is $176.99; the median-to-P90 spread is $95.49.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
The lowest published rate in this market is $55; the highest is $708.50.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
This benchmark is drawn from 1219 individual rate records that Anthem Blue Cross Blue Shield (GA) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
Medicare's national non-facility rate for CPT 92014 is $127.26, making the Anthem Blue Cross Blue Shield (GA) local median 64% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
23.7% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

1219 providers bill this code to this payer in this metro.

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These are the rates Anthem Blue Cross Blue Shield (GA) publishes for CPT 92014 (Eye exam, established patient, comprehensive) among Los Angeles-Long Beach-Anaheim, CA providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Anthem Blue Cross Blue Shield (GA)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (GA) to publish this rate. Page generated 2026-08-23 23:57 UTC; the live index is queried in real time on every request.