Retina scan (OCT) Cost by Hospital

Retina scan (OCT) is a diagnostic imaging scan. Prices are from 1018 US hospitals across 50 states, from their machine-readable files.

$101median cash price · 1018 hospitals, 50 statestypically $35–$260 depending on the hospital
≈ 3.1× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$182
Cash / self-pay
$101
Insurer-negotiated
$63
Medicare pays
$33
$35$260
Median cash $101  ·  Medicare $33  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $101 — about 3.1× the Medicare rate ($33). On the higher side. A fair cash price is usually within ~2× Medicare ($65).

💡 Asking for the cash price instead of the $182 list price could save about $80 (44%).

Estimate what you’ll pay
Quick fill:

Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
University of Michigan Health-Sparrow Carson Carson City, MI $18 $23 ★ 4/5 95 min 15.2%
Edward W Sparrow Hospital Lansing, MI $18 $23 ★ 3/5 301 min 13.6%
University of Michigan Health-Sparrow Clinton Saint Johns, MI $18 $23 ★ 4/5 183 min 15.0%
University of Michigan Health-Sparrow Eaton Charlotte, MI $18 $23 ★ 1/5 152 min 15.0%
Sparrow Ionia Hospital Ionia, MI $18 $23 ★ 2/5 158 min 15.2%
Jackson General Hospital Ripley, WV $18 — ★ 3/5 133 min 14.8%
Little Falls Hospital Little Falls, NY $18 $20 ★ 2/5 110 min 15.7%
Cobleskill Regional Hospital Cobleskill, NY $18 $23 ★ 4/5 109 min 14.6%
O'connor Hospital Delhi, NY $19 $27 — 88 min 14.7%
Potomac Valley Hospital Keyser, WV $20 — ★ 1/5 118 min 15.5%
Jefferson Medical Center Ranson, WV $20 — ★ 1/5 161 min 14.5%
Harrison Community Hospital Cadiz, OH $22 — — 84 min 15.2%
Barnesville Hospital Association, Inc Barnesville, OH $22 $4,513 — 113 min 15.0%
Nacogdoches Memorial Hospital Nacogdoches, TX $23 $60 ★ 2/5 178 min 15.4%
Red Bud Regional Hospital Red Bud, IL $27 $37 ★ 4/5 121 min 15.6%
Summersville Regional Medical Center Summersville, WV $30 — ★ 2/5 140 min 15.1%
Grinnell Regional Medical Center Grinnell, IA $30 $38 ★ 2/5 104 min 14.9%
Jones Regional Medical Center Anamosa, IA $30 $33 ★ 4/5 113 min 14.7%
University of Kansas Hospital Kansas City, KS $31 $93 ★ 5/5 307 min 14.1%
Grant Memorial Hospital Petersburg, WV $31 — ★ 3/5 105 min 15.4%
Grand River Hospital District Rifle, CO $32 $903 — 107 min 14.4%
St Lukes Magic Valley Medical Center Twin Falls, ID $32 $30 ★ 4/5 184 min 14.3%
St Luke's Regional Medical Center Boise, ID $32 $27 ★ 5/5 168 min 12.4%
St Luke's Nampa Medical Center Nampa, ID $32 $27 ★ 5/5 157 min 13.9%
St Luke's Jerome Jerome, ID $32 $30 — 101 min 14.8%

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated August 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Retina scan (OCT)

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $101; Medicare pays $33.

InsurerHospitalsNegotiated median
Univera 8
$23
$13 – $41
Priority Health 12
$31
$14 – $133
Medicaid 70
$32
$11 – $124
AmeriHealth 90
$34
$20 – $70
Geisinger 29
$37
$24 – $72
Anthem 203
$43
$15 – $147
Highmark 36
$49
$17 – $63
Medica 37
$53
$18 – $85
Harvard Pilgrim 14
$54
$20 – $184
Tricare / VA 101
$57
$23 – $70
Molina Healthcare 214
$57
$17 – $120
Humana 387
$57
$17 – $93
UnitedHealthcare 466
$57
$17 – $174
Amerigroup 53
$57
$16 – $65
Centene / Ambetter 275
$57
$17 – $99
Devoted Health 92
$58
$17 – $70
Sanford Health Plan 25
$59
$17 – $175
UPMC Health Plan 30
$59
$22 – $164
Aetna 445
$59
$17 – $175
Coventry 32
$60
$34 – $214
Medicare 171
$60
$24 – $76
UCare 32
$60
$17 – $117
HealthPartners 71
$63
$19 – $153
SelectHealth 24
$63
$21 – $153
Cigna 260
$63
$24 – $288
Independent Health 9
$70
$36 – $82
MVP Health Care 30
$70
$23 – $160
Security Health Plan 22
$72
$17 – $223
Oscar Health 61
$74
$28 – $105
Kaiser Permanente 56
$77
$25 – $367
Bright Health 8
$80
$77 – $86
Blue Cross Blue Shield 498
$81
$25 – $268
Workers' Comp / No-Fault 23
$92
$41 – $166
EmblemHealth 35
$96
$36 – $465
AvMed 9
$107
$34 – $187
Health Net 54
$115
$48 – $318
MultiPlan / PHCS network 138
$160
$51 – $309

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Michigan$32
Idaho$32
Kansas$40
Wisconsin$52
Iowa$54
New Hampshire$60

Prices by city

Chicago, ILAustin, TXNew York, NYBronx, NYCharlotte, NCCleveland, OHDallas, TXHouston, TXNashville, TNPhiladelphia, PASan Antonio, TXBrooklyn, NYFort Worth, TXLos Angeles, CAMilwaukee, WIRochester, NYArlington, TXAurora, COColorado Springs, COJacksonville, FLKansas City, MOKnoxville, TNPittsburgh, PAPlano, TX

Prices by state

TexasCaliforniaFloridaOhioNew YorkWisconsinIllinoisMinnesotaColoradoPennsylvaniaTennesseeNorth CarolinaMichiganIndianaNew JerseyLouisianaKansasMaineWest VirginiaOklahomaIowaWashingtonAlabamaMissouriMassachusettsIdahoUtahGeorgiaSouth CarolinaSouth DakotaArizonaKentuckyNorth DakotaNew HampshireMontanaVirginiaWyomingNebraskaConnecticutArkansasNevadaNew MexicoMaryland

Doctors who perform this

Clinicians who reported the most Medicare volume for this service. This reflects Original Medicare activity only and is a volume signal, not a quality ranking.

ClinicianSpecialtyLocationMedicare services
Wright Lauten, MDOphthalmologyHattiesburg, MS9,032
David Warrow, M.D.OphthalmologyHagerstown, MD9,007
Nathan Steinle, M.D.OphthalmologySanta Barbara, CA8,522
David Reed, M.D.OphthalmologyPlymouth, MA8,018
John Sullivan, MDOphthalmologyJacksonville, FL7,504
Babak Jian Seyedahmadi, M.D.OphthalmologyEast Weymouth, MA7,136
Alexander Eaton, MDOphthalmologyFort Myers, FL7,075
Allen Hu, MDOphthalmologyHagerstown, MD7,009
Torsten Wiegand, MDOphthalmologyBoston, MA6,893
Omesh Gupta, MDOphthalmologyPlymouth Meeting, PA6,853
Shawn Agee, M.D.OphthalmologyJacksonville, FL6,759
David Boyer, MDOphthalmologyLos Angeles, CA6,368

Browse doctors by specialty & city →

Does Medicare cover Retina scan (OCT)?

Yes — Medicare generally covers Retina scan (OCT). It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $33. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $7 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 1018 US hospitals across 50 states, the typical (median) cash price is $101, versus a chargemaster (list) price around $182, a median insurer-negotiated rate of $63, a Medicare rate of about $33. Most cash prices fall between $35 and $260 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Retina scan (OCT) cost without insurance?
The median cash (self-pay) price across 1018 US hospitals is $101. Most hospitals fall between $35 and $260. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Retina scan (OCT)?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $33). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Retina scan (OCT)?
Medicare pays about $33. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Retina scan (OCT) prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

Related Imaging & Radiology

Chest X-rayX-ray of the neck (cervical spine) (3 views)Chest X-ray (2 views)X-ray of the lower back (lumbar spine)X-ray of the neck (cervical spine)X-ray of the pelvisChest X-ray (1 view)Abdominal ultrasound

See more Imaging & Radiology.