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Eye Exam, New Patient, Comprehensive

Michigan rates for HCPCS 92004

This is a thorough initial eye examination for a patient new to the practice, including a detailed history, a full exam of the eye's structures and vision, and the start of a treatment or monitoring plan. It's more extensive than a basic vision check and is often used to evaluate new or complex eye concerns.

Rates data updated July 2026.

How much does Eye Exam, New Patient, Comprehensive cost?

$123

Typical physician fee. In Michigan, July 2026.

Insurers have agreed to pay about $123 for this service. Most negotiated rates run $91.20 to $158.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $123 · 10th to 90th $117 to $132Professionalmedian $126 · 10th to 90th $78 to $195
$100$200facility $123professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$123.03
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$204.17
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$141.25
Typical High
$147.91
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$141.25
Median
$144.54
Typical High
$144.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$177.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$112.20
Typical High
$112.20
CareSource
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$134.90
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$123.03
Typical High
$371.54
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$123.03
Typical High
$190.55
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$275.42
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$120.23
Typical High
$177.83

Where Michigan sits

The same service costs 1.6 times more in California than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 35th of 51

$123

CA $158DE $97.72

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.