Charges for Eye Care Services and Products - Self-Pay/Uninsured Patients

Overview

We want to be transparent in our pricing with all our patients. Below you will find charges for the services and products we provide. If you have questions regarding how much your care will cost, please speak with the office manager.

Please note that for some services, we give a large discount if our fees are paid on or before the day of service. We accept most major credit cards, checks, and cash. If your check is returned to us for non-payment, we will assess a charge to you according to our Terms and Conditions of Care (available at SEE-CARE.com), in addition to any collections charges.

These rates do not generally apply to insured patients, as rates for insured patients are set by our contract with the insurer. We usually can not tell you how much insurance will cover, as insurance plans vary. You can call your insurance company to find out how much they will cover. If you request it, our office manager can give you the billing codes for the charges below, which you will need when speaking with your insurance company. If a service is not covered by your insurance, you may be responsible for charges at the self-pay rate.

If you have financial need, please speak to the office manager, as we can provide reduced price care for financial hardship.

refraction (measurement of the optical defocus of the eye ... Paid up front: $80.00 Billed: $80.00
complex refraction ... Paid up front: $120.00 Billed $120.00
contact lens evaluation and renewal, established contact lens wearer ... Paid up front: $60.00 Billed $60.00
placement of bandage contact lens to treat eye surface disease ... Paid up front: $80.00 Billed: $100.00
contact lens evaluation with refit ... Paid up front: $100.00 Billed: $100.00
soft contact lens fitting and training (patient new to contact lenses) ... Paid up front: $150.00 Billed: $150.00
rigid gas permeable contact lens fitting and training ... Paid up front: $200.00 Billed: $200.00
complicated contact lens fitting and training(medical eye disease) ...Paid up front: $300.00 Billed: $300.00
undilated eye exam, new patient (no visits within 3 years) ... Paid up front: $161.40 Billed: $189.88
dilated eye exam, new patient (no visits within 3 years) ... Paid up front: $278.94 Billed: $328.16
undilated eye exam, established patient ... Paid up front: $167.11 Billed: $196.60
dilated eye exam, established patient ... Paid up front: $236.18 Billed: $277.86
new patient evaluation and management visit ... Paid up front: $288.27 Billed: $339.14
hospital visit, emergency department or inpatient, dilated eye exam ... Paid up front: $316.27 Billed: $316.27
refactometry (measurement of optics for glasses) ... Paid up front: $80.00 Billed: $80.00
gonioscopy (examination of intraocular drainage system) ... Paid up front: $51.95 Billed: $61.12
corneal topographic mapping ... Paid up front: $67.68 Billed: $79.62
visual field testing, non-full threshold ... Paid up front: $87.11 Billed: $102.48
visual field testing, full threshold ... Paid up front: $118.12 Billed: $138.96
optical coherence tomography, front of eye ... Paid up front: $58.72 Billed: $69.08
optical coherence tomography, optic nerve ... Paid up front: $68.77 Billed: $80.90
optical coherence tomography, retinal ... Paid up front: $75.74 Billed: $89.10
pachymetry (measurement of corneal thickness) ... Paid up front: $21.44 Billed: $25.22
retinal vascular angiography (fluorescein) ... Paid up front: $238.22 Billed: $280.26
retinal photography ... Paid up front: $69.41 Billed: $81.66
photography of external eye ... Paid up front: $44.13 Billed: $51.92
A-scan ultrasonography (measurement of eye for cataract surgery) ... Paid up front: $127.11 Billed: $149.54
partial coherence interferometry of eye (measuring eye for cataract surgery) ... Paid up front: $93.02 Billed: $109.44
extended ophthalmoscopy of retinal periphery ... Paid up front: $45.17 Billed: $53.14
extended ophthalmoscopy of macula ... Paid up front: $28.87 Billed: $33.96
incision and drainage of abcess ... Paid up front: $235.04 Billed: $276.52
drainage of hematoma ... Paid up front: $322.90 Billed: $379.88
removal of skin tags ... Paid up front: $170.32 Billed: $200.38
malignant lesion excision ... Paid up front: $388.03 Billed: $456.50
repair of eyelid, extensive ... Paid up front: $802.57 Billed: $944.20
wedge resection of eyelid margin ... Paid up front: $1,447.19 Billed: $1,702.58
full thickness skin graft ... Paid up front: $1,856.16 Billed: $2,183.72
removal of excess skin from upper eyelids ... Paid up front: $1,160.17 Billed: $1,364.90
removal of foreign body, conjunctiva ... Paid up front: $71.52 Billed: $84.14
removal of foreign body, cornea ... Paid up front: $125.43 Billed: $147.56
excision of pterygium, no graft ... Paid up front: $1,021.31 Billed: $1,201.54
excision of pterygium, with graft ... Paid up front: $1,263.51 Billed: $1,486.48
needling of bleb after glaucoma surgery ... Paid up front: $1,416.83 Billed: $1,666.86
stye drainage, one stye ... Paid up front: $238.87 Billed: $281.02
stye drainage, multiple, one eyelid ... Paid up front: $301.17 Billed: $354.32
stye drainage, multiple, different eyelids ... Paid up front: $376.99 Billed: $443.52
repair of eyelash malposition ... Paid up front: $35.04 Billed: $41.22
excision of lesion, eyelid margin ... Paid up front: $538.49 Billed: $633.52
snip of punctum ... Paid up front: $193.80 Billed: $228.00
punctal plug placement, one punctum ... Paid up front: $277.10 Billed: $326.00
probing of tear system under anesthesia ... Paid up front: $245.14 Billed: $315.06
probing of tear system ... Paid up front: $248.64 Billed: $292.52
placement of amniotic membrane on ocular surface ... Paid up front: $2,670.17 Billed: $3,141.38
selective laser trabeculoplasty ... Paid up front: $454.53 Billed: $439.14
implantation of tube shunt ... Paid up front: $2,081.84 Billed: $2,449.22
implantation of shunt to bleb (eg Xen stent or ExPress shunt) ... Paid up front: $1,883.18 Billed: $2,215.50
revision of tube shunt ... Paid up front: $1,558.78 Billed: $1,833.86
laser peripheral iridotomy (LPI) ... Paid up front: $558.74 Billed: $657.34
YAG laser capsulotomy ... Paid up front: $620.86 Billed: $730.42
repositioning of intraocular lens ... Paid up front: $1,558.08 Billed: $1,833.04
removal of lens particles ... Paid up front: $1,265.46 Billed: $1,488.78
complex cataract surgery ... Paid up front: $1,358.40 Billed: $1,598.12
cataract surgery with implantation of intraocular lens ... Paid up front: $992.32 Billed: $1,167.44
insertion of intraocular lens (separate procedure) ... Paid up front: $1,406.16 Billed: $1,654.30
exchange of intraocular lens ... Paid up front: $1,647.56 Billed: $1,938.30
YAG laser vitreolysis (laser for floaters) ... Paid up front: $721.31 Billed: $848.60
lysis of tarsorrhaphy ... Paid up front: $473.93 Billed: $557.56
tarsorrhaphy, temporary ... Paid up front: $348.59 Billed: $410.10
tarsorrhaphy, permanent ... Paid up front: $877.03 Billed: $1,031.80
repair of droopy eyelid, levator advancement ... Paid up front: $1,384.31 Billed: $1,628.60
repair of droopy eyelid, Mueller muscle-conjunctival resection ... Paid up front: $1,018.39 Billed: $1,198.10
repair of ectropion (eg tarsal strip or wedge resection) ... Paid up front: $1,179.63 Billed: $1,387.80
repair of entropion, suture (eg Quickert procedure) ... Paid up front: $912.92 Billed: $1,074.02
repair of entropion, extensive (eg tarsal fracture or tarsal strip) ... Paid up front: $1,229.75 Billed: $1,446.76
injection into vitreous, medication other than anti-VEGF ... Paid up front: $208.59 Billed: $245.40
injection of lesion ... Paid up front: $107.22 Billed: $126.14
Eylea injection into eye ...must be paid up front: $2,045.40
Avastin injection into eye ...must be paid up front: $263.59
Botox injection, therapeutic (not cosmetic) ...must be paid up front: $954.76
Family Medical Leave Act application, per application (initial or amended) ... Paid up front: $65.00 Billed: $75.00
Copy of complete medical record given or sent to patient, once per year ... $0.00
Copy of complete medical record given or sent to patient, within 1 year ... $0.25 per page
Copy of medical records given or sent to patient since last records sent, $0.00
Copy of complete medical record given or sent to attorney or other outide entity, ... $0.65 per page
Administrative forms, unspecified, per page ... Paid up front: $5.00 Billed: $8.00
Administrative time (eg arranging testing, prior authorization, insurance inquiries, pharmacy calls) per hour beyond 15 minutes ... Paid up front: $65.00 per hour Billed: $75.00 per hour

Prices effective February 28, 2024.

For patients receiving an estimate of charges:

Patient Name

Date

Received by (initial or sign)

Date of Service