Retina scan (OCT) Cost by Hospital

Retina scan (OCT) is a diagnostic imaging scan. Prices are from 1041 US hospitals across 50 states, from their machine-readable files.

$95median cash price · 1041 hospitals, 50 statestypically $35–$250 depending on the hospital
≈ 2.9× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$189
Cash / self-pay
$95
Insurer-negotiated
$63
Medicare pays
$33
$35$250
Median cash $95  ·  Medicare $33  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $95 — about 2.9× 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 $189 list price could save about $94 (50%).

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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
University of Michigan Health-Sparrow Carson Carson City, MI $18 $23 ★ 4/5 91 min —
Edward W Sparrow Hospital Lansing, MI $18 $23 ★ 3/5 299 min —
University of Michigan Health-Sparrow Clinton Saint Johns, MI $18 $23 ★ 4/5 182 min —
University of Michigan Health-Sparrow Eaton Charlotte, MI $18 $23 ★ 1/5 168 min —
Sparrow Ionia Hospital Ionia, MI $18 $23 ★ 2/5 158 min —
Jackson General Hospital Ripley, WV $18 — ★ 3/5 127 min —
Little Falls Hospital Little Falls, NY $18 $20 ★ 2/5 109 min —
Cobleskill Regional Hospital Cobleskill, NY $18 $23 ★ 4/5 111 min —
O'connor Hospital Delhi, NY $19 $27 — 95 min —
Potomac Valley Hospital Keyser, WV $20 — ★ 1/5 119 min —
Jefferson Medical Center Ranson, WV $20 — ★ 1/5 173 min —
Harrison Community Hospital Cadiz, OH $22 — — 82 min —
Barnesville Hospital Association, Inc Barnesville, OH $22 $4,513 — 115 min —
Nacogdoches Memorial Hospital Nacogdoches, TX $23 $61 ★ 2/5 174 min —
Red Bud Regional Hospital Red Bud, IL $27 $37 ★ 4/5 122 min —
Summersville Regional Medical Center Summersville, WV $30 — ★ 2/5 136 min —
Grinnell Regional Medical Center Grinnell, IA $30 $38 ★ 2/5 112 min —
Jones Regional Medical Center Anamosa, IA $30 $33 ★ 4/5 116 min —
University of Kansas Hospital Kansas City, KS $31 $93 ★ 5/5 307 min —
Grant Memorial Hospital Petersburg, WV $31 — ★ 3/5 110 min —
Grand River Hospital District Rifle, CO $32 $903 — 110 min —
St Lukes Magic Valley Medical Center Twin Falls, ID $32 $30 ★ 4/5 186 min —
St Luke's Regional Medical Center Boise, ID $32 $27 ★ 5/5 168 min —
St Luke's Nampa Medical Center Nampa, ID $32 $27 ★ 5/5 158 min —
St Luke's Jerome Jerome, ID $32 $30 — 100 min —

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 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: $95; Medicare pays $33.

InsurerHospitalsNegotiated median
Univera 8
$23
$13 – $41
Priority Health 11
$31
$14 – $133
Medicaid 72
$32
$11 – $123
AmeriHealth 94
$34
$20 – $70
Geisinger 31
$44
$24 – $79
Highmark 44
$46
$17 – $63
Medica 37
$53
$18 – $85
Harvard Pilgrim 14
$54
$20 – $184
Anthem 219
$54
$15 – $174
Molina Healthcare 216
$56
$16 – $113
Humana 398
$56
$17 – $93
Tricare / VA 104
$57
$24 – $70
Amerigroup 54
$58
$16 – $65
Centene / Ambetter 291
$58
$17 – $99
Devoted Health 97
$58
$17 – $70
UPMC Health Plan 33
$58
$17 – $164
Aetna 469
$59
$17 – $190
UnitedHealthcare 488
$59
$18 – $189
Sanford Health Plan 25
$59
$17 – $175
Coventry 34
$60
$33 – $206
Medicare 174
$60
$23 – $76
UCare 32
$60
$17 – $117
Cigna 289
$61
$19 – $281
HealthPartners 73
$63
$19 – $147
SelectHealth 24
$63
$21 – $153
Independent Health 9
$70
$36 – $82
MVP Health Care 32
$70
$23 – $163
Security Health Plan 22
$72
$17 – $223
Kaiser Permanente 55
$77
$25 – $367
Oscar Health 73
$79
$28 – $645
Bright Health 8
$80
$77 – $86
Blue Cross Blue Shield 506
$82
$25 – $268
Workers' Comp / No-Fault 23
$92
$41 – $166
AvMed 9
$107
$34 – $187
Health Net 56
$117
$48 – $315
EmblemHealth 50
$126
$43 – $465
MultiPlan / PHCS network 152
$160
$49 – $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
Georgia$10
Michigan$32
Idaho$32
Kansas$40
Wisconsin$52
Iowa$54

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 YorkWisconsinPennsylvaniaIllinoisMinnesotaColoradoTennesseeNorth CarolinaMichiganNew JerseyIndianaLouisianaKansasMaineWest VirginiaOklahomaIowaWashingtonAlabamaMissouriGeorgiaMassachusettsIdahoUtahSouth CarolinaSouth DakotaNew HampshireArizonaKentuckyNorth DakotaMontanaVirginiaWyomingNevadaNebraskaConnecticutArkansasNew 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 1041 US hospitals across 50 states, the typical (median) cash price is $95, versus a chargemaster (list) price around $189, a median insurer-negotiated rate of $63, a Medicare rate of about $33. Most cash prices fall between $35 and $250 — 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 1041 US hospitals is $95. Most hospitals fall between $35 and $250. 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.

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