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Billing code 81405 · Lab & pathology

81405 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $276.04 for 81405 across 39 states, from $13.50 in Arizona to $523.89 in Iowa.

Data as of Oct 5, 202639 statesEvery rate links to its official source

States publishing
39
National median
$276.04units vary by state
Lowest
$13.50Arizona
Highest
$523.89Iowa
Answer

What does Medicaid pay for 81405?

39 state Medicaid programs publish a fee-for-service rate for 81405. The national median is $276.04 (units differ between states). Iowa pays the most, $523.89, and Arizona the least, $13.50 per A, a 38.8x spread.

State ranking

81405 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 39 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2018-09-01$523.89——Plans must pay at least this—
2Kansas Source · since 2013-01-01$480.69——Plans must pay at least this—
3Arkansas Source · since 2025-03-26$480.68——Not classified—
19Vermont Source · since 2025-01-01$293.82——Not classified—
20Virginia Source · since 2013-05-01$276.04——Plans negotiate; applies out of network—
21Missouri Source · since 2026-07-01$271.22——Plans negotiate; applies out of network—
38Florida Source · since 2026-01-01$66.72——Plans negotiate; applies out of network—
39Arizona Source · since 2021-10-01$13.50A—Plans negotiate; applies out of network—
See all 39 states for 81405 — start free

31 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 81405 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 81405?

It depends on the state. Of the 39 states with a published fee-for-service rate, the median is $276.04. Iowa pays the most ($523.89) and Arizona the least ($13.50 per A).

Which state pays the highest Medicaid rate for 81405?

Iowa, at $523.89, effective 2018-09-01.

Do managed-care plans pay the same rate for 81405?

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.