Routine eye exam Cost by Hospital

Routine eye exam is a clinic or emergency-department visit. Prices are from 1061 US hospitals across 50 states, from their machine-readable files.

$143median cash price · 1061 hospitals, 50 statestypically $51–$385 depending on the hospital
≈ 1.6× Medicare · Reasonable vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$241
Cash / self-pay
$143
Insurer-negotiated
$133
Medicare pays
$88
$51$385
Median cash $143  ·  Medicare $88  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $143 — about 1.6× the Medicare rate ($88). Reasonable. A fair cash price is usually within ~2× Medicare ($175).

💡 Asking for the cash price instead of the $241 list price could save about $98 (41%).

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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
Adventist Health Tulare Tulare, CA $22 $43 ★ 3/5 198 min —
New Ulm Medical Center New Ulm, MN $23 $33 ★ 5/5 100 min —
Tamarack Health Ashland Medical Center Ashland, WI $24 $32 ★ 3/5 124 min —
Saint Vincent Hospital Erie, PA $24 $63 ★ 4/5 219 min —
Jefferson Hospital Louisville, GA $25 $63 — 99 min —
Jefferson Hospital Jefferson Hills, PA $25 $63 ★ 4/5 170 min —
Westfield Memorial Hospital, Inc Westfield, NY $29 $69 — 120 min —
Canonsburg General Hospital Canonsburg, PA $29 $63 ★ 3/5 155 min —
Forbes Hospital Monroeville, PA $29 $63 ★ 3/5 261 min —
Ochsner Medical Center Acute New Orleans, LA $29 $118 ★ 4/5 174 min —
University of Michigan Health System Ann Arbor, MI $30 $47 ★ 4/5 345 min —
Grove City Medical Center Grove City, PA $30 $63 ★ 4/5 150 min —
Beloit Health System Beloit, WI $31 $60 ★ 3/5 129 min —
Allegheny Valley Hospital Natrona, PA $32 $63 ★ 4/5 203 min —
Allegheny General Hospital Pittsburgh, PA $32 $63 ★ 3/5 274 min —
Signature Healthcare Brockton Hospital Brockton, MA $33 $155 ★ 3/5 208 min —
University of Kansas Hospital Kansas City, KS $33 $124 ★ 5/5 307 min —
O'connor Hospital Delhi, NY $33 $47 — 95 min —
Ahn Wexford Hospital Wexford, PA $34 $63 ★ 5/5 184 min —
West Penn Hospital Pittsburgh, PA $36 $63 ★ 3/5 208 min —
Little Falls Hospital Little Falls, NY $36 $41 ★ 2/5 109 min —
Altru Hospital Grand Forks, ND $36 $159 ★ 3/5 177 min —
Milton S Hershey Medical Center Hershey, PA $38 $131 ★ 4/5 261 min —
Arkansas Children's Hospital Little Rock, AR $39 $124 — — —
Arkansas Children's Northwest, Inc Springdale, AR $39 $124 — — —

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 October 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 Routine eye exam

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: $143; Medicare pays $88.

InsurerHospitalsNegotiated median
Univera 9
$46
$37 – $55
Medicaid 77
$53
$28 – $110
Priority Health 10
$57
$29 – $133
Highmark 37
$60
$43 – $245
AmeriHealth 74
$63
$44 – $81
Geisinger 23
$69
$63 – $86
Workers' Comp / No-Fault 28
$106
$60 – $203
Medica 40
$108
$37 – $161
Sanford Health Plan 25
$109
$45 – $228
UnitedHealthcare 500
$120
$41 – $303
Molina Healthcare 209
$121
$38 – $229
Coventry 34
$122
$46 – $167
HealthPartners 65
$123
$43 – $228
Tricare / VA 111
$123
$48 – $162
Humana 422
$124
$43 – $188
Devoted Health 98
$126
$96 – $153
UPMC Health Plan 30
$126
$36 – $356
Anthem 198
$126
$43 – $262
Medicare 190
$126
$45 – $171
UCare 31
$126
$41 – $223
Aetna 485
$127
$46 – $257
Amerigroup 63
$128
$41 – $164
Security Health Plan 21
$128
$43 – $1,473
Cigna 311
$130
$42 – $303
Centene / Ambetter 310
$130
$42 – $232
Independent Health 9
$153
$30 – $165
MVP Health Care 29
$153
$40 – $367
Kaiser Permanente 83
$164
$90 – $380
Harvard Pilgrim 12
$167
$60 – $289
Health Net 51
$168
$70 – $330
Blue Cross Blue Shield 496
$169
$56 – $467
Bright Health 8
$175
$168 – $188
MultiPlan / PHCS network 155
$197
$66 – $359
SelectHealth 25
$201
$119 – $398
Oscar Health 76
$202
$85 – $645
Healthcare Highways 5
$227
$64 – $709
EmblemHealth 53
$229
$30 – $1,050
AvMed 7
$233
$59 – $296

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
North Dakota$36
Michigan$49
Virginia$58
Kansas$62
Indiana$65
Kentucky$65

Prices by city

Prices by state

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.

Does Medicare cover Routine eye exam?

Yes — Medicare generally covers Routine eye exam. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $88. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $18 — 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 1061 US hospitals across 50 states, the typical (median) cash price is $143, versus a chargemaster (list) price around $241, a median insurer-negotiated rate of $133, a Medicare rate of about $88. Most cash prices fall between $51 and $385 — 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 Routine eye exam cost without insurance?
The median cash (self-pay) price across 1061 US hospitals is $143. Most hospitals fall between $51 and $385. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Routine eye exam?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $88). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Routine eye exam?
Medicare pays about $88. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Routine eye exam 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.

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