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Eye Exam, New Patient, Comprehensive

Missouri 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?

$129

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $129 from a physician practice, and about $115 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$129$93.33 to $155
FacilityA hospital or hospital-owned outpatient department$115$72.44 to $145

How much rates vary

Facilitymedian $115 · 10th to 90th $72 to $219Professionalmedian $129 · 10th to 90th $72 to $195
$50$100$200facility $115professional $129

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
$72.44
Median
$72.44
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$128.82
Typical High
$194.98
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$138.04
Median
$213.80
Typical High
$288.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$141.25
Typical High
$190.55
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$138.04
Median
$138.04
Typical High
$354.81
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$181.97
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$147.91
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$134.90
Typical High
$275.42
Medica
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$131.83
Typical High
$251.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$169.82
Typical High
$954.99
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$165.96
Median
$177.83
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$112.20
Typical High
$204.17

Where Missouri 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.

Missouri· 26th of 51

$129

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.