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Billing code 86794 · Lab & pathology

86794 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $15.83 for 86794 across 44 states, from $5.20 in Kansas to $20.80 in Arkansas.

Data as of Oct 5, 202644 statesEvery rate links to its official source

States publishing
44
National median
$15.83units vary by state
Lowest
$5.20Kansas
Highest
$20.80Arkansas
Answer

What does Medicaid pay for 86794?

44 state Medicaid programs publish a fee-for-service rate for 86794. The national median is $15.83 (units differ between states). Arkansas pays the most, $20.80, and Kansas the least, $5.20, a 4.0x spread.

State ranking

86794 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 44 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$20.80——Not classified—
2Iowa Source · since 2018-01-01$19.96——Plans must pay at least this—
3Wyoming Source · since 2021-01-01$18.25——Not classified—
22New York Source · since 2020-05-29$16.07——Plans negotiate; applies out of network—
23Louisiana Source · since 2018-01-01$15.60——Plans must pay at least this—
24Arizona Source · since 2026-10-01$15.17——Plans negotiate; applies out of network—
43Florida Source · since 2026-01-01$9.10——Plans negotiate; applies out of network—
44Kansas Source · since 2018-01-01$5.20——Not classified—
See all 44 states for 86794 — start free

36 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 86794 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 86794?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $15.83. Arkansas pays the most ($20.80) and Kansas the least ($5.20).

Which state pays the highest Medicaid rate for 86794?

Arkansas, at $20.80, effective 2025-03-26.

Do managed-care plans pay the same rate for 86794?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.